Schasfoort Fabiënne C, Bussmann Johannes B J, Krijnen H John, Stam Henk J
Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, P.O. Box 1738, 3000DR Rotterdam, The Netherlands.
Eur J Pain. 2006 Jan;10(1):31-9. doi: 10.1016/j.ejpain.2005.01.005.
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.
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.
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.
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.
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.
已开发出一种上肢活动监测仪（ULAM）来确定1型复杂性区域疼痛综合征（CRPS1）中的活动受限情况。ULAM基于对身体节段加速度的24小时动态监测，能够在横向研究中对活动能力和上肢活动进行有效且客观的量化。
在一项纵向研究中，探讨使用ULAM测量的急性上肢CRPS1患者上肢活动随时间的变化情况，并将其与活动受限和功能障碍的其他结局指标的时间进程进行比较。
在一个治疗方案期间，对4名受试者进行了4次测量。使用了几种与上肢使用和活动能力相关的ULAM结局指标、三份问卷（RASQ、DASH、RAND36）以及六个功能障碍结局指标（视觉模拟评分法 - 瞬间疼痛、用力引起的疼痛视觉模拟评分法、体积、温度、主动活动范围、力量）。
客观测量的上肢活动经常改善；在最终评估时，63%的ULAM结局指标有超过5%的改善。与其他问卷相比，ULAM结局指标的时间进程与身体部位及CRPS1特定问卷RASQ更为相似。温度受损的时间进程最常与ULAM一致，而两个视觉模拟评分法的一致性最低。
使用ULAM客观测量发现，上肢活动随时间有明显变化，且ULAM与其他结局指标的时间进程之间的关系在很大程度上是可以解释的。ULAM能够有效评估CRPS1患者上肢活动随时间的变化情况，但测量间的变异性需要仔细考虑。
