Treatment of Complex Regional Pain Syndrome, a Long-term Follow-up

Study Overview
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Brief Summary
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Complex regional pain syndrome, CRPS, is an uncommon but often very disabling chronic pain syndrome characterized by, beside pain: sensory disturbances, peripheral autonomic changes and inflammatory features. The diagnosis is subdivided in CRPS type 1 where no nerve injury has been identified, and CRPS type 2 when a major nerve injury has been verified. A combination of exposure in vivo, a form of behaviour therapy where the patient is gradually confronted with avoided movements and activities, and interventions directly targeting a hypothesized cortical reorganisation is an interesting novel approach for treating CRPS. The present study consists of (1) a qualitative interview study with 10-15 subjects that has received this form of treatment, in order to better understand their experience and effects of the treatment, and (2) a case series with long-term follow-up of 3-5 subjects that received the treatment för 5-8 years ago, in order to study the long term effects of the treatment.

Official Title
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Treatment of Complex Regional Pain Syndrome, a Qualitative Interview Study and a Case Series With Long-term Follow-up

Conditions
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Complex Regional Pain Syndromes, Chronic Pain

Intervention / Treatment
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* Behavioral: Multimodal rehabilitation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Has participated in multimodal treatment for CRPS at Uppsala University Hospital Exclusion Criteria: Other serious physical or mental condition

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| CRPS<br> | Behavioral: Multimodal rehabilitation<br>* A combination of exposure in vivo and interventions directly targeting the cortical reorganization for treating CRPS.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diagnosis | Whether the subject still fulfill diagnostic criteria for CRPS | 1 day | 
| Subjective experience | A qualitative interview targeting the subjects own experience of the treatment and its effect | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Level of pain | Subjective level of pain on a Likert-scale 0-10 (NRS) | 1 day | 
| Subjective experience of quality of life | Quality of life, measured with the RAND-36 (0-100, higher scores mean a better outcome) | 1 day | 
| Global impression of change | Global impression of change measured with a single question (0-6, higher scores mean a better outcome) | 1 day | 
| Acceptance of pain | Measured with the Chronic Pain Acceptance Questionnaire, CPAQ (0-156, higher scores mean a better outcome) | 1 day (0-156, higher scores mean a better outcome) | 
| Fear of pain | Measured with the Tampa Scale of Kinesiophobia, TSK (0-52, lower scores mean a better outcome) | 1 day (0-52, lower scores mean a better outcome) | 
| Pain catastrophizing | Measured with Pain Catastrophizing Scale, PCS (0-52, lower scores mean a better outcome) | 1 day (0-52, lower scores mean a better outcome) | 
| Avoidance of activities | Measured with the Photograph Series of Daily Activities, PHODA (0-100, lower scores mean a better outcome) | 1 day (0-100, lower scores mean a better outcome) | 
| Neglect of the affected limb | Measured with a five item questionnaire (0-36, lower scores mean a better outcome) | 1 day (0-36, lower scores mean a better outcome) | 
| Subjective experience of quality of life 2 | EuroQol 5D, EQ-5D (0-15, higher scores means a better outcome) | 1 day | 
| Subjective experience of quality of life 3 | Life Satisfaction Questionnaire, LiSat 11 (11-66, higher scores means a better outcome) | 1 day |