The Effectiveness of Rehabilitation Interventions on Pain and Disability for Complex Regional Pain Syndrome

医学 心理干预 奇纳 物理疗法 梅德林 康复 随机对照试验 复杂局部疼痛综合征 物理医学与康复 分级(工程) 手法治疗 荟萃分析 循证医学 替代医学 精神科 外科 内科学 病理 法学 土木工程 工程类 政治学
作者
Erfan Shafiee,Joy C. MacDermid,Tara Packham,David M. Walton,Ruby Grewal,Maryam Farzad
出处
期刊:The Clinical Journal of Pain [Ovid Technologies (Wolters Kluwer)]
卷期号:39 (2): 91-105 被引量:10
标识
DOI:10.1097/ajp.0000000000001089
摘要

To summarize and critically appraise the body of evidence on conservative management of complex regional pain syndrome (CRPS), we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs).We conducted a literature search from inception to November 2021 in the following databases: Embase, Medline, CINAHL, Google Scholar, PEDRO, and Psychinfo. Two independent reviewers conducted risk of bias and quality assessment. Qualitative synthesis and meta-analysis were the methods for summarizing the findings of the RCTs. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to rate the overall quality and certainty of the evidence on each treatment outcome.Through a database search, 751 records were found, and 33 RCTs were eligible for inclusion. Studies were published between 1995 and 2021. The overall risk of bias for 2 studies was low, 8 studies were unclear, and 23 studies were high.Low-quality evidence suggests that mirror therapy (as an addition to conventional stroke rehabilitation interventions) and graded motor imagery program (compared with routine rehabilitation interventions) may result in a large improvement in pain and disability up to 6-month follow-up in poststroke CRPS-1 patients. Low-quality evidence suggests that pain exposure therapy and aerobic exercises as an additive treatment to physical therapy interventions may result in a large improvement in pain up to a 6-month follow-up. The evidence is very uncertain about the effect of all other targeted interventions over conventional physical therapy or sham treatments on pain and disability.There is an ongoing need for high-quality studies to inform conservative management choices in CRPS.
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