No impaired hemoglobin oxygenation in forearm muscles of patients with chronic CRPS-1.
OBJECTIVE
Physiotherapy is considered an important treatment option in patients with upper limb complex regional pain syndrome type-1 (CRPS-1). In case of chronic CRPS-1, exercise therapy of the affected limb forms an important part of the physiotherapeutic program. We investigated whether muscle loading in chronic CRPS-1 patients is associated with impairments in muscle circulation of the forearm of the affected limb.


METHODS
Thirty patients with chronic CRPS-1 unilaterally affecting their upper limbs, and 30 age-matched and sex-matched control participants were included in this study. Local muscle blood flow and hemoglobin oxygenation were measured by near infrared spectroscopy within the muscles of the forearm at rest, after 1-minute isometric handgrip exercises, and after arterial occlusion. Main outcome parameters were: local muscle blood flow, O2 consumption (mVO2), and postischemic reoxygenation (ReOx).


RESULTS
We found no differences in baseline muscle blood flow, mVO2, and ReOx between the affected CRPS-1, unaffected CRPS-1, and control arms. After exercise, mVO2 of the affected CRPS-1 arms was not different from the clinically unaffected CRPS-1 arms. Furthermore, in comparison with the control arms, unaffected CRPS-1 arms showed no difference in mVO2 or ReOx.


CONCLUSIONS
Muscle loading does not seems to be related to impairments in muscle oxygen uptake in forearm muscles of upper limbs affected by chronic CRPS-1. Our results suggest that exercise therapy can be safely used in physiotherapeutic training programs for chronic CRPS-1 of the upper limb.
Brunnekreef
Jaap J J
JJ
Department of Physiotherapy, Research Center for Allied Health Sciences, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. jbrunnekreef@hotmail.com
Oosterhof
Jan
J
Wolff
André P
AP
Crul
Ben J P
BJ
Wilder-Smith
Oliver H G
OH
Oostendorp
Rob A B
RA
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005542:Forearm / Q000473:pathology / Q000503:physiopathology*; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism*; D010100:Oxygen / Q000378:metabolism*; D010108:Oxyhemoglobins / Q000378:metabolism; D010147:Pain Measurement; D012019:Reflex Sympathetic Dystrophy / Q000473:pathology / Q000503:physiopathology*; D012039:Regional Blood Flow / Q000502:physiology; D019265:Spectroscopy, Near-Infrared / Q000379:methods; D018709:Statistics, Nonparametric
D006454:Hemoglobins; D010108:Oxyhemoglobins; D010100:Oxygen