title: Adjuvant physical therapy versus occupational therapy in patients with reflex sympathetic dystrophy/complex regional pain syndrome type I.
abstract: 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.
authors.affiliation: Allied Health Services, University Hospital Nijmegen, The Netherlands.
authors.forename: H M
authors.initials: HM
authors.lastname: Oerlemans
authors.forename: R A
authors.initials: RA
authors.lastname: Oostendorp
authors.forename: T
authors.initials: T
authors.lastname: de Boo
authors.forename: L
authors.initials: L
authors.lastname: van der Laan
authors.forename: J L
authors.initials: JL
authors.lastname: Severens
authors.forename: J A
authors.initials: JA
authors.lastname: Goris
mesh_terms: 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