Psychological Intervention and Physiotherapy With Medication Improves CRPS Patients Outcome

Study Overview
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Brief Summary
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A ten week open label study intervention to evaluate the outcome for a psychological intervention combined with physiotherapy and medication with memantine-morphine in 10 CRPS patients.

Detailed Description
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Ten CRPS I patients attended an intervention for 10 weeks. First, the medication was started with morphine 10mg adding gradually to 30 mg per day. Then, in addition to morphine, memantine 5 mg was started adding the dose gradually up to 40 mg per day if tolerated. Physiotherapy and psychological intervention were mostly carried out in a weekly group gathering with home exercises that were recorded to a diary. Psychological and physiotherapy interventions lasted for eight weeks. A neurological examination was done before and after the intervention as well as a separate physiotherapist examination of the hands. Patients filled out questionnaires of mood, quality of life, pain, and CRPS descriptions before and after the intervention.

Official Title
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Psychological Intervention and Physiotherapy With Medication Improves CRPS Patients Outcome

Conditions
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CRPS

Intervention / Treatment
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* Drug: Morphine, memantine
* Behavioral: Psychological intervention
* Other: Physiotherapy intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: CRPS type 1 for at least 6 months, pain NRS 4 or more Exclusion Criteria: major psychiatric or neurological disease

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: intervention<br>Open label study with psychological intervention and physiotherapy intervention with medication of morphine, memantine for ten weeks (morphine 30mg tbl per day and memantine up to 40mg tbl per day if tolerated). | Drug: Morphine, memantine<br>* Morphine up to 30 mg per day orally and memantine up to 40 mg per day orally if tolerated for 10 weeks.<br>* Other names: Depolan (morphine), Ebixa (memantine);Behavioral: Psychological intervention<br>* To help patients shift perspective from pain and CRPS-symptoms, to increase body awareness, to create vivid imagenary, to increase the use of a CRPS hand with mindfulness exposure exercises, to increase flexibility in behavioral repertoire, to explore the fusion of emotions, automatic cognitions and learned responses and to help patients to integrate new skills in their lives.<br>Other: Physiotherapy intervention<br>* Graded motor imagenary with group and individual weekly sessions with daily practices at home.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Direction of change in patient reported CRPS symptom discriptors | Reports of CRPS symptoms | Three months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Direction of change in motor parameters | Measurements of strength of the hand, the active range of motion in the hand/arm, 9HPT, DASH questionnaire | Three months | 
| Direction of change in psychological parameters | Patient scores in BDI, PASS-20, CPAQ | Three months | 
| Direction of change in quality of life | Patient scores in 15D | Three months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CRPS, intervention, multimodal