Prediction of reflex sympathetic dystrophy in hemiplegia by evaluation of hand edema.

OBJECTIVE

To determine the predictive value of measurements of hand edema for the development of reflex sympathetic dystrophy (RSD).

DESIGN

Cohort study.

SETTING

Departments of rehabilitation medicine in 3 general hospitals and 1 rehabilitation hospital in Japan.

PARTICIPANTS

Thirty-four stroke patients.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Measurement of the circumference of the middle finger was used to evaluate hand edema. The degree of hand edema was expressed by the ratio of circumference of the middle finger (RCMF) in the affected side to that in the uninvolved extremity.

RESULTS

Eight of 34 patients developed clinical RSD from 2 to 4 months after stroke. Hand edema showed a significant relationship to the development of RSD (ie, the patients who had an RCMF of above 1.06 at 4 weeks poststroke had significantly higher incidence of RSD than those with a lower RCMF; P=.0127).

CONCLUSION

It is possible to predict the development of RSD in hemiplegia by measuring hand edema 4 weeks poststroke.