Ann Rehabil Med.  2020 Jun;44(3):218-227. 10.5535/arm.19084.

Understanding the Rehabilitation Needs of Korean Patients With Complex Regional Pain Syndrome

Affiliations
  • 1Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
  • 2Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  • 3Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea

Abstract


Objective
To evaluate the current status of pain severity and quality of life (QoL) in patients with complex regional pain syndrome (CRPS), and to assess both their perceived needs and any unmet needs of current rehabilitation services.
Methods
A single-center questionnaire-based survey was conducted on 47 patients with CRPS who were diagnosed based on Budapest’s criteria. It collected demographic and clinical data, and the structured questionnaire included the Brief Pain Inventory (BPI), the Korean version of the World Health Organization Disability Assessment Schedule II (WHODAS-K II), as well as the 5-Level EuroQol-5D (EQ-5D-5L) for measuring the QoL.
Results
The average value of BPI and WHODAS-K II were 7.69%±2.26% and 70.49%±19.22%, respectively. In the evaluation of their perceived needs and unmet needs for rehabilitation, patients had the highest rehabilitation needs in terms of pain (95.74%), followed by bodyaches (80.85%). Regarding their unmet needs, patients had the highest unmet needs in terms of memory impairment (83.33%), followed by weight management (72.00%). According to the regression analysis, only the overall BPI was significantly associated with QoL (p=0.01), and a higher BPI value led to poorer results for QoL.
Conclusion
In Korea, patients with CRPS do not receive adequate rehabilitation, and they are not satisfied with current received treatments. A more structured and individualized rehabilitation treatment plan is required to manage every aspect related to chronic pain, and provision should be made for improved care guidelines for future CRPS management.

Keyword

Complex regional pain syndromes; Quality of life; Rehabilitation

Figure

  • Fig. 1. Rehabilitation needs, unmet needs and satisfaction. Values are presented as percentage (%). ADL, activities of daily living.


Reference

1. Yung Chung O, Bruehl SP. Complex regional pain syndrome. Curr Treat Options Neurol. 2003; 5:499–511.
Article
2. Galve Villa M, Rittig-Rasmussen B, Moeller Schear Mikkelsen L, Groendahl Poulsen A. Complex regional pain syndrome [published correction appears in Musculoskelet Sci Pract. 2019 Oct;43:127]. Man Ther. 2016; 26:223–30.
3. Sandroni P, Benrud-Larson LM, McClelland RL, Low PA. Complex regional pain syndrome type I: incidence and prevalence in Olmsted county, a populationbased study. Pain. 2003; 103:199–207.
Article
4. de Mos M, de Bruijn AG, Huygen FJ, Dieleman JP, Stricker BH, Sturkenboom MC. The incidence of complex regional pain syndrome: a population-based study. Pain. 2007; 129:12–20.
Article
5. Bussa M, Mascaro A, Cuffaro L, Rinaldi S. Adult complex regional pain syndrome type I: a narrative review. PM R. 2017; 9:707–19.
Article
6. Harden RN, Bruehl S, Stanton-Hicks M, Wilson PR. Proposed new diagnostic criteria for complex regional pain syndrome. Pain Med. 2007; 8:326–31.
Article
7. Bruehl S. Complex regional pain syndrome. BMJ. 2015; 351:h2730.
Article
8. Rome L. The place of occupational therapy in rehabilitation strategies of complex regional pain syndrome: comparative study of 60 cases. Hand Surg Rehabil. 2016; 35:355–62.
Article
9. Smart KM, Wand BM, O’Connell NE. Physiotherapy for pain and disability in adults with complex regional pain syndrome (CRPS) types I and II. Cochrane Database Syst Rev. 2016; 2:CD010853.
Article
10. Nedeljkovic UD. How to treat complex regional pain syndrome in rehabilitation settings? Acta Chir Iugosl. 2013; 60:69–75.
Article
11. Lagueux E, Charest J, Lefrancois-Caron E, Mauger ME, Mercier E, Savard K, et al. Modified graded motor imagery for complex regional pain syndrome type 1 of the upper extremity in the acute phase: a patient series. Int J Rehabil Res. 2012; 35:138–45.
12. D’Arcy Y, Werdell J. Complex regional pain syndrome: treatment and rehabilitation options. Nursing. 2008; 38 Suppl Therapy:2–3.
13. Moseley GL. Is successful rehabilitation of complex regional pain syndrome due to sustained attention to the affected limb? A randomised clinical trial. Pain. 2005; 114:54–61.
Article
14. Moseley GL. Graded motor imagery is effective for long-standing complex regional pain syndrome: a randomised controlled trial. Pain. 2004; 108:192–8.
Article
15. Bussa M, Guttilla D, Lucia M, Mascaro A, Rinaldi S. Complex regional pain syndrome type I: a comprehensive review. Acta Anaesthesiol Scand. 2015; 59:685–97.
Article
16. Miller C, Williams M, Heine P, Williamson E, O’connell N. Current practice in the rehabilitation of complex regional pain syndrome: a survey of practitioners. Disabil Rehabil. 2019; 41:847–53.
Article
17. Song Y, Song HJ, Han HR, Park SY, Nam S, Kim MT. Unmet needs for social support and effects on diabetes self-care activities in Korean Americans with type 2 diabetes. Diabetes Educ. 2012; 38:77–85.
Article
18. Liossi C, Clinch J, Howard R. Need for early recognition and multidisciplinary management of paediatric complex regional pain syndrome. BMJ. 2015; 351:h4748.
Article
19. Grieve S, Adams J, McCabe C. ‘What I Really Needed Was the Truth’: exploring the information needs of people with complex regional pain syndrome. Musculoskeletal Care. 2016; 14:15–25.
Article
20. Yun YH, Mendoza TR, Heo DS, Yoo T, Heo BY, Park HA, et al. Development of a cancer pain assessment tool in Korea: a validation study of a Korean version of the brief pain inventory. Oncology. 2004; 66:439–44.
Article
21. Brooks R, Rabin R, De Charro F. The measurement and valuation of health status using EQ-5D: a European perspective: evidence from the EuroQol BIOMED Research Programme. Boston, MA: Springer;2003.
22. Kim SH, Ahn J, Ock M, Shin S, Park J, Luo N, et al. The EQ-5D-5L valuation study in Korea. Qual Life Res. 2016; 25:1845–52.
Article
23. Shiroiwa T, Ikeda S, Noto S, Igarashi A, Fukuda T, Saito S, et al. Comparison of value set based on DCE and/or TTO data: scoring for EQ-5D-5L health states in Japan. Value Health. 2016; 19:648–54.
Article
24. Kim JM, Stewart R, Glozier N, Prince M, Kim SW, Yang SJ, et al. Physical health, depression and cognitive function as correlates of disability in an older Korean population. Int J Geriatr Psychiatry. 2005; 20:160–7.
Article
25. Shin DW, Park JH, Shim EJ, Hahm MI, Park JH, Park EC. Predictors and outcomes of feeling of insufficient consultation time in cancer care in Korea: results of a nationwide multicenter survey. Support Care Cancer. 2012; 20:1965–73.
Article
26. Jo JM, Hwang JH, Lee CH, Kang HJ, Yu JN. The need of cancer patients for rehabilitation services. J Korean Acad Rehabil Med. 2010; 34:691–700.
27. Kim JG, Nam HS, Hwang B, Shin HI. Access to medical services in Korean people with spinal cord injury. Ann Rehabil Med. 2014; 38:174–82.
Article
28. Yang EJ, Lee SY, Kim K, Jung SH, Jang SN, Han SJ, et al. Factors associated with reduced quality of life in polio survivors in Korea. PLoS One. 2015; 10:e0130448.
Article
29. Hwang J. Understanding reasons for unmet health care needs in Korea: what are health policy implications? BMC Health Serv Res. 2018; 18:557.
Article
30. Kuo CY, Liou TH, Chang KH, Chi WC, Escorpizo R, Yen CF, et al. Functioning and disability analysis of patients with traumati c brain injury and spinal cord injury by using the world health organization disability assessment schedule 2.0. Int J Environ Res Public Health. 2015; 12:4116–27.
31. Barnhoorn KJ, van de Meent H, van Dongen RT, Klomp FP, Groenewoud H, Samwel H, et al. Pain exposure physical therapy (PEPT) compared to conventional treatment in complex regional pain syndrome type 1: a randomised controlled trial. BMJ Open. 2015; 5:e008283.
Article
32. Goebel A, Barker CH, Turner-Stokes L, Atkins RM, Cameron H, Cossins L. Complex regional pain syndrome in adults: UK guidelines for diagnosis, referral and management in primary and secondary care. London: The Royal College of Physicians;2012.
33. Veloso AG, Sperling C, Holm LV, Nicolaisen A, Rottmann N, Thayssen S, et al. Unmet needs in cancer rehabilitation during the early cancer trajectory: a nationwide patient survey. Acta Oncol. 2013; 52:372–81.
34. Richards GC, Lluka LJ, Smith MT, Haslam C, Moore B, O’Callaghan J, et al. Effects of long-term opioid analgesics on cognitive performance and plasma cytokine concentrations in patients with chronic low back pain: a cross-sectional pilot study. Pain Rep. 2018; 3:e669.
Article
35. Gierthmuhlen J, Binder A, Baron R. Mechanismbased treatment in complex regional pain syndromes. Nat Rev Neurol. 2014; 10:518–28.
Article
36. Allin S, Grignon M, Le Grand J. Subjective unmet need and utilization of health care services in Canada: what are the equity implications? Soc Sci Med. 2010; 70:465–72.
Article
37. Mollborn S, Stepanikova I, Cook KS. Delayed care and unmet needs among health care system users: when does fiduciary trust in a physician matter? Health Serv Res. 2005; 40(6 Pt 1):1898–917.
Article
38. Kim JG, Nam HS, Hwang B, Shin HI. Access to medical services in Korean people with spinal cord injury. Ann Rehabil Med. 2014; 38:174–82.
Article
39. Brunner F, Bachmann LM, Weber U, Kessels AG, Perez RS, Marinus J, et al. Complex regional pain syndrome 1: the Swiss cohort study. BMC Musculoskelet Disord. 2008; 9:92.
Article
40. Shenker N, Goebel A, Rockett M, Batchelor J, Jones GT, Parker R, et al. Establishing the characteristics for patients with chronic Complex Regional Pain Syndrome: the value of the CRPS-UK Registry. Br J Pain. 2015; 9:122–8.
Article
Full Text Links
  • ARM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr