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The long-term effect of complex regional pain syndrome type 1 on disability and quality of life after foot injury.

par Mouraux, Dominique ;Lenoir, Cédric ;Tuna, Turgay ;Brassinne, Eric ;Sobczak, Stéphane
Référence Disability and rehabilitation, page (1-9)
Publication Publié, 2019-08-01

Article révisé par les pairs

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Résumé :

Purpose: To study the long-term evolution of patients with lower-limb Complex Regional Pain Syndrome (CRPS), focusing on functional and proprioceptive aspects and quality of life. Methods: In 20 patients suffering from chronic distal lower-limb CRPS diagnosed using Budapest criteria, we assessed joint position sense and strength of the knee muscles at the CRPS and unaffected leg, functional exercise capacity, pain, CRPS severity score, quality of life and kinesiophobia. Similar assessments were performed in 20 age-matched controls. Results: The joint position performance (at 45°) was significantly lower for the CRPS leg as compared to controls. The knee extensor strength of the CRPS leg was significantly reduced as compared to the unaffected leg (-27%) and controls (-42%). CRPS patients showed significantly reduced performance at the 6 min-walk test as compared to their age group predicted value and controls. Patients suffering from CRPS for 3.8 years in average still exhibit high pain, severity and kinesiophobia scores. Conclusions: Long-term deficits in strength and proprioceptive impairments are observed at the knee joint of the CRPS leg. This persistent functional disability has significant repercussions on the quality of life. We highlight the importance of including strength and proprioceptive exercises in the therapeutic approaches for CPRS patients. IMPLICATIONS FOR REHABILITATION The long-term evolution of patients suffering from lower-limb Complex Regional Pain Syndrome is associated with persistent disability, pain and impacts the quality of life. Strength, proprioceptive, functional and subjective assessments are necessary to better identify deficits. Rehabilitation should focus on the overall deficit of the affected and contralateral limb.