Adjuvant physical therapy versus occupational therapy in patients with reflex sympathetic dystrophy/complex regional pain syndrome type I.
OBJECTIVE
To investigate the effectiveness and cost of physical therapy (PT) or occupational therapy (OT) in patients with reflex sympathetic dystrophy (RSD).


METHODS
Prospective randomized controlled trial, with 1 year follow-up.


METHODS
Two university hospitals.


METHODS
One hundred thirty-five patients who had been suffering from RSD of one upper extremity for less than 1 year.


METHODS
Patients were assigned to PT, OT, or a control group (social work).


METHODS
Improvement in impairment level sumscore (ISS) over 1 year (Student's t test). A difference of 5 ISS points between the groups was defined as being clinically relevant. Furthermore, severity of disability and handicap was measured and tested exploratively (Wilcoxon; alpha = .05), and cost-effectiveness of the groups was calculated.


RESULTS
PT and, to a lesser extent, OT resulted in a significant and also more rapid improvement in the ISS as compared with controls (6 and 4 ISS points, respectively). On a disability level, a positive trend was found in favor of OT. On a handicap level, no differences were found between the groups. PT had an advantage over OT regarding the cost-effectiveness ratio.


CONCLUSIONS
In different ways PT and OT each contribute to the recovery from RSD of the upper extremity.
Oerlemans
H M
HM
Allied Health Services, University Hospital Nijmegen, The Netherlands.
Oostendorp
R A
RA
de Boo
T
T
van der Laan
L
L
Severens
J L
JL
Goris
J A
JA
D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000191:economics*; D010147:Pain Measurement; D026741:Physical Therapy Modalities / Q000191:economics*; D012019:Reflex Sympathetic Dystrophy / Q000145:classification / Q000534:rehabilitation*; D016037:Single-Blind Method; D016896:Treatment Outcome