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Objective:To investigate the clinical efficacy of repetitive transcranial magnetic stimulation (rTMS) versus functional electrical stimulation (FES) in the treatment of post-stroke complex regional pain syndrome. Methods:The randomized controlled study included 60 patients with post-stroke complex regional pain syndrome who received treatment at the Wenzhou TCM Hospital of Zhejiang Chinese Medical University from July 2021 to February 2023. These patients were divided into an rTMS group ( n = 30) and an FES group ( n = 30) using a random number table method. Patients in the rTMS group were treated with rTMS, while those in the FES group were treated with FES. All treatments were performed once daily for 8 consecutive weeks. The clinical efficacy, total active movement score of the fingers, Fugl-Meyer assessment scale score, Activity of Daily Living score, modified Barthel Index score, shoulder joint range of motion, and safety were compared between the two groups. Results:The total response rate in the FES group was 86.7% (26/30), which was significantly higher than 83.3% (25/30) in the rTMS group ( Z = 0.09, P = 0.93). After treatment, there were no significant differences between the two groups in terms of total active movement score of the fingers and Fugl-Meyer assessment scale score ( P = 0.244, 0.262). No significant differences were found between the two groups in MBI score and ADL score (both P > 0.05). There was also no significant difference in shoulder joint range of motion between the two groups ( P > 0.05). Conclusion:Both rTMS and FES are highly effective for post-stroke complex regional pain syndrome. They can improve upper limb function, enhance daily living abilities, and remodel neurological functions of the brain.
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Abstract Cast immobilization is used in the management of various injuries of joints and/or limbs. A variety of nail disorders have been reported in association with cast immobilization of the forearm and wrist among a limited number of patients so far. The mechanism was not clearly identified in some of these cases. Here, the authors report two patients with nail disorders appeared after the removal of immobilization cast of forearm and wrist and review the literature.
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Humanos , Antebraço , Doenças da Unha/etiologia , Punho , Imobilização/efeitos adversosRESUMO
RESUMEN Fundamento: el síndrome doloroso regional complejo es una condición incapacitante y a menudo crónica, que se ha mantenido como una de las enfermedades más enigmáticas desde su descubrimiento hace 150 años y se presenta entre el dos y el cinco por ciento de la población adulta, y hasta el 20 % de la población pediátrica. Objetivo: profundizar y actualizar los aspectos más importantes del síndrome doloroso regional complejo. Métodos: se realizó una revisión de la literatura en idioma español e inglés disponible en PubMed Central, Hinari y SciELO. Para ello se utilizaron los siguientes descriptores: complex regional pain syndrome, sympathetic reflex dystrophy, Sudeck dystrophy, algodystrophy. A partir de la información obtenida se realizó una revisión bibliográfica de un total de 167 artículos publicados, de ellas se seleccionaron 40 citas para realizar la revisión, 38 de los últimos cinco años. Resultados: se insistió en aquellos tópicos importantes dentro del tema como son: reseña histórica, epidemiología, fisiopatología, presentación clínica, diagnóstico, estudios complementarios y tratamiento. Conclusiones: el síndrome doloroso regional complejo es un trastorno doloroso enigmático y visible. La comprensión de la compleja fisiopatología ha logrado avances significativos, que llevarán a la desmitificación y a la mejoría en las terapias. A pesar de los tratamientos disponibles y los que se encuentran en estudio, no existen protocolos estandarizados que permitan un abordaje multidisciplinario.
ABSTRACT Background: complex regional pain syndrome is a painful disabling and often chronic condition that remains as one of the most enigmatic diseases since its discovery 150 years ago and presents between the 2 % and the 5 % of adult population and up to the 20 % in children. Objective: to update and to deepen in the most important aspects of regional complex pain syndrome. Methods: a revision of the literature was made in English and Spanish, available in PubMed Central, Hinari and SciELO was carried out. The following descriptors were used: complex regional pain syndrome, sympathetic reflex dystrophy, Sudeck dystrophy, algodystrophy. Based on the obtained data, a bibliographic revision was made of 167 publishing articles, including 40 citations selected for the research, 38 of them of the last five years. Results: it was focus in those controversial topics like: history, epidemiology, physiopathology, clinical presentation, diagnosis, complementary studies and treatment. Conclusions: regional complex pain syndrome is a painful enigmatic and visible disorder. The understanding of the complex physiopathology has improved significant advances that will rule out the myth and will perform better therapies. Besides available treatments and which are in study, no standardized protocols are in hand which allows a multidisciplinary approach.
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Objective To study the effect of electric stimulation combined with Ai salt bag on shoulderhand syndrome after cerebral infarction.Methods A total of 188 patients with shoulder-hand syndrome after cerebral infarction admitted to Taizhou Central Hospital from September 2015 to August 2018 were enrolled in the study,they were randomly divided into study group (n =94) and control group (n =94) according to the random number table method.The control group was given uplink electrical stimulation treatment based on the conventional treatment for cerebral infarction and rehabilitation training,the study group was given Ai salt bag treatment on the basis of the control group.The clinical treatment effect,pain and edema VAS score,Fugl-Meyer motor function score and ADL score were observed and compared between the two groups.Results After 28 days of treatment,the total effective rate was 88.30% (83/94) in the study group and 76.60% (72/94) in the control group,the difference between the two groups was statistically significant (x2 =4.447,P < 0.05).The VAS score of edema degree and pain degree in the study group decreased from (4.13 ± 1.40) points,(3.43 ± 2.20) points to (1.70 ± 1.36) points,(1.52 ±1.22) points,which in the control group decreased from (4.10 ± 1.46) points,(3.40 ± 2.17) points to (2.79 ±1.58) points,(2.52 ± 1.18) points,there were statistically significant differences between the two groups after treatment (t1 =5.712,t2 =5.069,all P < 0.05).The Fugl-Meyer motor function score and ADL score of the study group increased from (19.91 ± 13.32) points,(42.34 ± 15.57)points to (54.21 ± 11.71) points,(86.02 ±16.62)points,which in the control group increased from (20.74 ± 11.30) points,(45.84 ± 14.44) points to(45.44 ± 12.61) points,(78.84 ± 17.79)points,there were statistically significant differences between the two groups after treatment (t1 =4.941,t2 =2.859,all P < 0.05).Conclusion Electrical stimulation combined with Ai salt bag in the treatment of shoulder-hand syndrome after cerebral infarction has significant clinical effect,which can effectively alleviate the pain symptoms and swelling of the affected limb,promote the activities of daily living and improve the function of the affected limb,and is worthy of clinical application.
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OBJECTIVE@#To observe the clinical effects of zheng's massage combined with electroacupuncture in the treatment ofreflex sensory dystrophy syndrome of the wrist.@*METHODS@#From October 2016 to September 2018, 48 cases of reflex sensory dystrophy syndrome of the wrist were divided into the observation group and the control group. In the observation group, there were 24 cases, including 10 males and 14 females, ranging in age from 54 to 76 years old, with an average age of (61.41 ±7.90) years old. The patients in the observation group were treated with massage combined with electroacupuncture. The control group consisted of 24 patients, including 9 males and 15 females, ranging in age from 52 to 75 years old, with an averageage of (58.71±8.11 ) years old. The patients in the control group were treated with electroacupuncture alone. All the patients in both groups were treated for 6 weeks. The clinical symptoms and signs, visual anglogue scale (VAS), Cooney wrist score and clinical efficacy evaluation were compared between the two groups before and after treatment, and statistical analysis was conducted.@*RESULTS@#After 6 weeks of treatment, VAS in the control group was 4.9±1.8, and Cooney wrist score was 74.63±1.72; VAS in the observation group was 2.2±1.4, and Cooney wrist score was 86.31±2.53. The comprehensive scores of VAS and Cooney wrist joint between two groups were improved after treatment, and the observation group was better than control group(<0.05). The curative effect of the observation group was better than that of the control group.@*CONCLUSION@#Zheng's massage combined with electroacupuncture has the following advantages in the treatment of reflex sympathetic dystrophy syndrome of the wrist, such as small trauma, patients' willingness promoting functional rehabilitation, which is worthy of clinical promotion.
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Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Eletroacupuntura , Massagem , Distrofia Simpática Reflexa , Terapêutica , Resultado do Tratamento , Punho , Articulação do PunhoRESUMO
The long-term prognosis of complex regional pain syndrome is difficult to predict because of its unclear pathophysiology. The syndrome can spontaneously spread to other regions in the body. We report a case in which a complex regional pain syndrome that occurred in a 75-year-old male patient after a stroke spread to the opposite side.
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Idoso , Humanos , Masculino , Causalgia , Prognóstico , Distrofia Simpática Reflexa , Acidente Vascular CerebralRESUMO
ABSTRACT BACKGROUND AND OBJECTIVES: The complex regional pain syndrome is characterized by presenting autonomic, sensory and motor difficult to control changes of the chronic evolution. Its pathophysiology and treatment are not fully defined, and the search for an increasingly effective treatment is a subject of medical concern. The involvement of the orofacial region has an even rarer incidence, and the literature reports only 14 cases in five decades. The objective of this report was to warn physicians and researchers about the importance of a correct diagnosis and to show the possibility of controlling this dysfunction with conservative treatment. CASE REPORT: A 68-year-old female patient, who after a facial trauma and three subsequent surgical procedures, developed orofacial complex regional pain syndrome. Several therapeutic regimens were performed, and after the last one she became completely asymptomatic: oxcarbazepine (900mg/day), morphine-controlled liberation (120mg/day), fluoxetine (40mg/day) and clonazepam (2mg/day), electrotherapy and oral rehabilitation. CONCLUSION: The diagnosis criteria for complex regional pain syndrome recommended by the International Association for the Study of Pain, revised in 2007, should be followed. The treatment of this neuropathic syndrome includes anticonvulsants, tricyclics, opioids, electrotherapy and somatic and stellate ganglion block, the latter when the pain is maintained by the sympathetic nervous system. In this report of an orofacial complex regional pain syndrome II, pain control was shown without the need for sympathetic ganglion block, which can be a warning to the medical class to a correct diagnosis and an effective and less invasive treatment.
RESUMO JUSTIFICATIVA E OBJETIVOS: A síndrome complexa de dor regional se caracteriza por apresentar alterações autonômicas, sensitivas e motoras de evolução crônica de difícil controle. Sua fisiopatologia não está totalmente definida e a busca por um tratamento cada vez mais eficaz é objeto de preocupação médica. O comprometimento da região orofacial tem uma incidência ainda mais rara e a literatura relata apenas 14 casos em cinco décadas. O objetivo deste relato foi alertar médicos e pesquisadores para a importância de um diagnóstico correto e mostrar a possibilidade de controle dessa disfunção com o tratamento conservador. RELATO DO CASO: Paciente do sexo feminino, 68 anos, após trauma facial e três intervenções cirúrgicas posteriores, desenvolveu quadro de síndrome complexa de dor regional orofacial. Foram realizados vários esquemas terapêuticos, o último dos quais tornou-a completamente assintomática: oxcarbazepina (900mg/dia), morfina de liberação controlada (120mg/dia), fluoxetina (40mg/dia) e clonazepam (2mg/dia), eletroterapia e reabilitação oral. CONCLUSÃO: Os critérios de diagnóstico para a síndrome complexa de dor regional, preconizados pela International Association for the Study of Pain, revisados em 2007, devem ser seguidos. O tratamento desta síndrome neuropática inclui anticonvulsivantes, tricíclicos e opioides, eletroterapia, bloqueio somático e de gânglio estrelado, este último quando a dor for mantida pelo sistema nervoso simpático. Neste relato de uma síndrome complexa de dor regional II orofacial foi mostrado o controle da dor sem a necessidade de bloqueio do gânglio simpático, o que pode alertar a classe médica para um correto diagnóstico e um tratamento eficaz e menos invasivo.
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Se efectuó un estudio descriptivo y transversal de 17 pacientes con síndrome doloroso regional complejo, que recibieron rehabilitación en el Departamento de Fisioterapia del Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba, desde enero 2016 hasta febrero 2017, con vistas a caracterizarles según aspectos clínicos y radiográficos. Entre los principales resultados predominaron el tipo 1 de la enfermedad (64,7 por ciento), la etapa precoz (25,0 por ciento), la localización en el miembro superior (82,4 por ciento) y el sexo femenino (58,8 por ciento), entre otros. La corrección postural y la cinesiterapia fueron necesarias independientemente del estadio clínico de la enfermedad. Se concluye que resulta importante efectuar un diagnóstico clínico y radiográfico oportuno, así como ejecutar medidas rehabilitadoras tempranas para evitar la discapacidad y lograr una recuperación funcional óptima
A descriptive and cross-sectional study of 17 patients with complex painful regional syndrome who received rehabilitation in the Physiotherapy Department of Dr Juan Bruno Zayas Alfonso Teaching General Hospital was carried out in Santiago de Cuba, from January, 2016 to February, 2017, aimed at characterizing them according to clinical and radiographical aspects. Among the main results there was a prevalence of the type 1 of the disease (64.7 percent), early stage (25.0 percent), localization in the upper member (82.4 percent) and the female sex (58.8 percent), among others. The postural correction and kinesiotherapy were necessary independently of the clinical stage of the disease. It was concluded that it is important to make an appropriate clinical and radiographic diagnosis, as well as to implement early rehabilitative measures to avoid disability and achieve a good functional recovery
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Humanos , Masculino , Feminino , Dor/reabilitação , Distrofia Simpática Reflexa/reabilitação , Síndrome de Colisão do Ombro/reabilitação , Especialidade de Fisioterapia/métodos , Estudos Transversais , Síndrome de Colisão do Ombro/epidemiologiaRESUMO
ABSTRACT Objective: The aim of this study was to identify factors associated with developing complex regional pain syndrome (CRPS) after surgical treatment for distal radius fracture (DRF). Methods: This case-control study analyzed patients seen from January 2014 to January 2016. Results: In our sample of 249 patients, 4% developed CRPS. Associated factors were economic compensation via work disability (odds ratio [OR] 14.3), age (OR 9.38), associated fracture (OR 12.94), and level of impact (OR 6.46), as well as psychiatric history (OR 7.21). Conclusions: Economically-productive aged patients with a history of high-impact trauma and patients with a history of psychiatric disorders have greater risk of developing CRPS after DRF. Level of Evidence III, Case-Control Study.
RESUMO Objetivo: Este estudo tem como objetivo identificar fatores de risco associados ao desenvolvimento de síndrome de dor regional complexa (CRPS) após o tratamento cirúrgico da fratura distal do rádio (DRF). Métodos: Este estudo de caso/controle analisou pacientes atendidos de janeiro de 2014 a janeiro de 2016. Resultados: Em nossa amostra de 249 pacientes, 4% desenvolveram CRPS. Os fatores associados foram compensação econômica (razão de chances [RC] 14,3), idade (RC 9,38), fratura associada (RC 12,94) e nível de impacto (RC 6,46), bem como história psiquiátrica (RC 7,21). Conclusões: Os pacientes com idade produtiva e história de trauma de alto impacto e os com história de transtornos psiquiátrico têm maior risco de desenvolver CRPS depois de DRF. Nível de Evidência III, Estudo de Caso Controle.
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Objective To investigate the effect of pregabalin capsules in the treatment of shoulder hand syndrome after stroke.Methods 90 patients with shoulder hand syndrome after stroke were divided into observation group and control group according to random number table method,45 cases in each group.Rehabilitation training and acupuncture treatment were used in the control group,and on the basis of the control group,the observation group used pregabalin capsules treatment,initial dose 75mg/times,oral,2 times/d.After 2 weeks,the dose was changed to 150mg/times,oral,2 timnes/d.Maintenance therapy for 8 weeks.The overall efficacy and pain degree before and after treatment,upper limb function of the two groups were compared.Results After treatment,the VAS scores of the two groups were significantly decreased,and the FMA scores were significantly increased,the differences were statistically significant compared with before treatment(t =17.353,15.777,12.001,10.432,all P < 0.05).And the improvement degrees of VAS score and FMA score of the observation group were significantly better than those of the control group [(18.3 ± 12.9) points vs.(29.8 ± 12.1) points,(53.1 ± 9.2) points vs.(42.3 ± 8.9) points],the differences were statistically significant(t =3.294,4.672,all P < 0.05).The total effective rate of the observation group was 93.3%,which was significantly higher than 77.8% of the control group,the difference was statistically significant (x2 =4.406,P < 0.05).Conclusion In the treatment of shoulder hand syndrome after stroke,pregabalin capsules has good effect.
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Objective To observe the clinical efficacy of yang-supplementing thread-embedding (acupoint embedded with catgut soaked in Shenfu injection) in treating shoulder-hand syndrome after cerebral stroke. Method Totally 120 patients were randomized into a treatment group and a control group, 60 cases in each group. The treatment group was intervened by acupoint thread-embedding, while the control group was by conventional acupuncture. The changes of symptoms, joint range of motion (ROM), pain, and Fugl-Meyer Assessment (FMA), and general therapeutic efficacy were observed after 30 d treatment. Result The total effective rate was 95.0% in the treatment group versus 85.0% in the control group, and the difference was statistically significant (P<0.05). Conclusion Yang-supplementing thread-embedding and conventional acupuncture both can mitigate pain induced by shoulder-hand syndrome, increase the range of motion, and significantly improve the upper-limb motor function, while the effect of yang-supplementing thread-embedding is superior to that of conventional acupuncture.
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Objective To explore the effect of electroacupuncture plus rehabilitation on shoulder-hand syndrome (SHS). Method Eighty SHS patients were randomized into an experimental group and a control group, 40 cases in each group. The experimental group was intervened by electroacupuncture plus rehabilitation training and basic Western medicine treatment, while the control group was by rehabilitation training and Western medicine treatment, 3 sessions a week, 4 weeks in total. The pain intensity of the affected shoulder and upper-limb motor function were observed before and after the treatment. The therapeutic efficacy was also evaluated. Result The Visual Analogue Scale (VAS) score of the shoulder pain and Fugl-Meyer Assessment (FMA) score of the upper-limb motor function were significantly improved after the intervention in the two groups (P<0.01), and the improvements of VAS and FMA in the experimental group were more significant than that in the control group (P<0.01). Conclusion Based on the basic treatment of Western medicine, electroacupuncture plus rehabilitation training can markedly improve the pain intensity of the affected shoulder and upper-limb motor function in post-stroke shoulder-hand syndrome.
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Objective To investigate the clinical efficacy of superficial needling plus external washing with Chinese herbal medicine in treating post-stroke shoulder-hand syndrome.Methods Sixty patients with post-stroke shoulder-hand syndrome were randomly allocated to treatment and control groups, 30 cases each. The treatment group received superficial needling plus external washing with Chinese herbal medicine and the control group, conventional acupuncture. Pain severity was assessed using the visual analogue scale (VAS) and upper limb function was assessed using the Fugl-Meyer Assessment (FMA) of motor recovery in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results The total efficacy rate was 96.7% in the treatment group and 83.3% in the control group; there was a statistically significant difference between the two groups (P<0.05). There were statistically significant pre-/post-treatment differences in the VAS score and the FMA score in the two groups (P<0.05). There were statistically significant post-treatment differences in the VAS score and the FMA score between the treatment and control groups (P<0.05).Conclusion Superficial needling plus external washing with Chinese herbal medicine is an effective way to treat post-stroke shoulder-hand syndrome.
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Objective To investigate the clinical efficacy of Jin’s Three Needles plus twelve Jing-Well points in treating post-stroke shoulder-hand syndrome. Methods Sixty patients meeting the inclusion criteria of post-stroke shoulder-hand syndrome were randomly allocated to treatment and control groups, 30 cases each. The treatment group received acupuncture with Jin’s Three Needles plus twelve Jing-Well points and the control group, conventional acupuncture. The Clinical Neurological Disfunction Scale (CNDS) score, the Fugl-Meyer Assessment (FMA) score, the Visual Analogue Scale (VAS) score and the Functiional Comprehensive Assessment (FCA) score were observed in the two groups before and after two weeks of treatment. The clinical therapeutic effects were compared between the two groups. Results There were statistically significant pre-/post-treatment differences in the CNDS, FMA, VAS and FCA scores in the two groups (P<0.05). The total efficacy rate and the cure and marked efficacy rate were 96.7%and 55.7%in the combination group, respectively, in the treatment group and 83.3%and 26.7%, respectively, in the control group;there were statistically significant differences between the two groups (P<0.05). Conclusion Acupuncture with Jin’s Three Needles plus twelve Jing-Well points is an effective way to treat post-stroke shoulder-hand syndrome.
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Objective To observe the clinical efficacy of micro-invasive point-through-point thread-embedding in treating acute stage of post-stroke shoulder-hand syndrome. Method Sixty patients were randomized into a treatment group and a control group, 30 in each group. Patients in the treatment group were intervened by micro-invasive point-through-point thread-embedding in addition to rehabilitation training, while patients in the control group were by rehabilitation training alone. Before treatment and after 4-week treatments, Visual Analogue Scale (VAS) was used to estimate shoulder pain, modified Barthel Index (MBI) to detect the activities of daily life, and Fugl-Meyer Assessment Scale to measure the motor function of upper limb. Result Before treatment, there were no significant differences in comparing the involved indexes between the two groups (P>0.05), and the indexes were significantly improved after intervention in both groups (P<0.05). Conclusion Micro-invasive point-through-point thread-embedding can reduce pain intensity, improve the activities of daily life and motor function of upper limb of patients in acute stage of post-stroke shoulder-hand syndrome.
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Objective To observe the clinical efficacy of acupuncture plus medicine and function training in treating post-stroke shoulder-hand syndrome. Method Sixty patients with post-stroke shoulder-hand syndrome were randomized into a treatment group of 30 cases and a control group of 30 cases. The treatment group was intervened by acupuncture plus medicine and functional training, while the control group was only by functional training. Before and after intervention, the hand swelling degree, Visual Analogue Scale (VAS), shoulder joint motion scale, Fugl-Meyer Assessment (FMA) scale were used to measure the swelling and pain of hand, motion of shoulder, and motor function of upper limb. Result After intervention, the swelling and pain of hand, motion range of shoulder and motor function of upper limb were significantly improved in both groups (P<0.01), and the improvements in the treatment group were more significant than that in the control group (P<0.05). Conclusion Acupuncture plus medicine and function training can enhance the efficacy in treating post-stroke shoulder-hand syndrome, superior to pure function training.
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Objective To explore the clinic effect of micro course in health education for prevention shoulder-hand syndrome in patients with stoke.Method The 42 stoke patients treated in our sector from October 2013 to September 2014 were observed (observation group) under health education by micro course,taking the 45 stoke patients treated in our sector from October 2012 to September 2013 as control group under traditional health education.Heahh education evaluation,occurrence rate of shoulder-hand syndrome,shoulder joint passive range of motion (ROM) and simple test for evaluating hand function (STEF) of the two groups of patients were compared after one and three months,respectively.Results Compared to the control group,the observation group made higher evaluation of health education method,showed lower occurrence rate of shoulder-hand syndrome,better shoulder joint passive ROM and upper limb movement function.In the time point of 1 and 3 months after the intervention,the incidence rate of shoulder-hand syndrome in the observation group was 2.5%(1/40) and 7.5%(3/40) respectively,which was significant lower than that of in the control group (19.05%,8/42 and 47.63%,20/40 respectively),thex2 value was 4.173 and 16.340 respectively,P<0.05.In the time point of 1 and 3 months after the intervention,the passive ROM in the observation group was (172.80 ± 15.18)° and (174.76 ± 7.45)°,which was significant higher than that of in the control group,(143.81 ± 22.76)° and (132.12 ± 16.67)° respectively,the t value was 6.816 and 15.074respectively,P<0.01.Conclusion Micro course used in health education of stroke patients could stimulate their study interests and activity,which played an important role in shoulder-hand syndrome occurrence prevention,shoulder injury reduction and upper limb function restoration acceleration.
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Objective To observe the therapeutic efficacy of acupuncture at the interiorly-exteriorly related meridians plus rehabilitation training in treating post-stroke shoulder-hand syndrome. Methods Sixty eligible patients with post-stroke shoulder-hand syndrome were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by acupuncture at the interiorly-exteriorly related meridians plus rehabilitation training, while the control group was by rehabilitation training alone. After 2 treatment courses, the Fugl-Meyer Assessment (FMA), visual analogue scale (VAS) and edema score were observed and compared. Results The FMA, VAS, and edema scores were significantly changed in both groups after intervention (P<0.01). There were significant differences in comparing the FMA, VAS, and edema scores between the two groups after intervention (P<0.05). The total effective rate was 83.3%in the treatment group versus 76.7%in the control group, and the difference was statistically significant (P<0.05). Conclusion Acupuncture at the interiorly-exteriorly related meridians plus rehabilitation is an effective method in treating post-stroke shoulder-hand syndrome.
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El Síndrome de Dolor Regional Complejo (SDRC) es una enfermedad crónica, que se caracteriza por dolor y alteraciones sensitivas, motoras y autonómicas, a menudo sigue a trauma de un miembro, su curso es variable y, tanto su fisiopatología como el tratamiento, no están claramente establecidos. El objetivo de esta revisión es presentar una actualización de los aspectos generales de la enfermedad y mostrar parte de la evidencia existente en relación a las alternativas terapéuticas de la misma, tanto las conservadoras como las intervencionales. Es importante tener en consideración algunos puntos que limitan el objetivo de obtención de evidencia de buena calidad para el tratamiento de este síndrome. Lo primero es que el diagnóstico es clínico y los criterios para realizarlo han variado en el tiempo. Segundo, es la ausencia de criterios estandarizados para medir los resultados al tratamiento. Y, por último, ya que se trata de un síndrome crónico cuya manifestación principal es el dolor, existe respuesta a placebo...
The Regional Pain Syndrome Complex (CRPS ) is a chronic disease, which is characterized by pain and sensory, motor and autonomic disturbances, often follows trauma, the course and the pathophysiology are variable. The aim of this review is to provide an update on the general aspects of the disease and show the evidence in relation to therapeutic alternatives...