Short- and long-term outcomes of children with complex regional pain syndrome type I treated with exercise therapy.
OBJECTIVE
To report the initial and long-term outcome after an intensive exercise therapy program for childhood complex regional pain syndrome, type I (CRPS).


METHODS
Prospective follow-up.


METHODS
A children's hospital.


METHODS
We followed 103 children (87 girls; mean age = 13.0 years) with CRPS. Forty-nine subjects were followed for more than 2 years (mean = 5 years 3 months).


METHODS
An intensive exercise program (most received a daily program of 4 hours of aerobic, functionally directed exercises, 1-2 hours of hydrotherapy, and desensitization). No medications or modalities were used. All had a screening psychological evaluation, and 79 (77%) were referred for psychological counseling.


METHODS
Outcomes included pain, presence of physical dysfunction, or recurrent episodes of CRPS or other disproportional musculoskeletal pain.


RESULTS
The mean duration of exercise therapy was 14 days, but over the past 2 years has decreased to 6 days. Ninety-five children (92%) initially became symptom free. Of those followed for more than 2 years, 43 (88%) were symptom free (15, or 31 %, of these patients had had a reoccurrence), 5 (10%) were fully functional but had some continued pain, and 1 (2%) had functional limitations. The median time to recurrence was 2 months; 79% of the recurrences were during the first 6 months after treatment.


CONCLUSIONS
Intense exercise therapy is effective in initially treating childhood CRPS and is associated with low rate of long-term symptoms or dysfunction.
Sherry
D D
DD
Department of Pediatrics, University of Washington, Children's Hospital & Medical Center, Seattle 98105, USA. dsherry@u.washington.edu
Wallace
C A
CA
Kelley
C
C
Kidder
M
M
Sapp
L
L
D000293:Adolescent; D000328:Adult; D002648:Child; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006875:Hydrotherapy; D008297:Male; D011446:Prospective Studies; D011581:Psychological Tests; D012008:Recurrence; D012019:Reflex Sympathetic Dystrophy / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome