title: Upper limb activity over time in complex regional pain syndrome type 1 as objectively measured with an upper limb-activity monitor: an explorative multiple case study.
abstract: BACKGROUND
  An upper limb-activity monitor (ULAM) has been developed to determine activity limitations in complex regional pain syndrome type 1 (CRPS1). The ULAM is based on 24h ambulatory monitoring of body segment accelerations and enables valid and objective quantification of mobility and upper limb activity in transversal studies.
  
  
  OBJECTIVE
  To explore upper limb activity over time in acute upper limb CRPS1 as measured with the ULAM in a longitudinal study, and to compare this to time courses of other outcome measures for activity limitations and impairments.
  
  
  METHODS
  Four subjects were measured four times during a treatment protocol. Several ULAM outcome measures related to upper limb usage and mobility, three questionnaires (RASQ, DASH, RAND36), and six impairment outcome indicators (VAS-momentary pain, VAS-pain resulting from effort, volume, temperature, active range of motion, strength) were used.
  
  
  RESULTS
  Objectively measured upper limb activity frequently improved; improvements of >5% were found for 63% of the ULAM outcome measures at final assessment. The ULAM outcome measures had a time course more similar to the body-part and CRPS1 specific questionnaire RASQ than the other questionnaires. The time course of impaired temperature was most often in accordance with the ULAM, and both VAS scores showed least accordance.
  
  
  CONCLUSIONS
  Clear changes in upper limb activity over time were frequently found as objectively measured with the ULAM, and relationships among the time courses of the ULAM and other outcome measures were largely explainable. The ULAM can validly assess upper limb activity over time in CRPS1, but between-measurement variability needs careful consideration.
authors.affiliation: Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, P.O. Box 1738, 3000DR Rotterdam, The Netherlands. f.schasfoort@erasmusmc.nl
authors.forename: Fabiënne C
authors.initials: FC
authors.lastname: Schasfoort
authors.forename: Johannes B J
authors.initials: JB
authors.lastname: Bussmann
authors.forename: H John
authors.initials: HJ
authors.lastname: Krijnen
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Stam
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation; D009043:Motor Activity / Q000502:physiology*; D017063:Outcome Assessment, Health Care; D012019:Reflex Sympathetic Dystrophy / Q000503:physiopathology* / Q000628:therapy; D011795:Surveys and Questionnaires; D034941:Upper Extremity / Q000502:physiology*