Jamroz Andrew, Berger Michael, Winston Paul
University of British Columbia, Island Medical Program, Victoria, British Columbia, Canada.
Division of Physical Medicine & Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Pain Res Manag. 2020 Feb 25;2020:8182569. doi: 10.1155/2020/8182569. eCollection 2020.
The objective of this study was to evaluate prednisone effectiveness on complex regional pain syndrome (CRPS) features in a community-based outpatient rehabilitation setting.
A single-centre, retrospective inception cohort design was used. Inclusion criteria were CRPS diagnosis according to the Budapest criteria, involvement of multiple joints, treatment with prednisone, and duration of symptoms less than one year. Typical prednisone treatment was 28-day taper regimen with 60 mg. Patient symptoms and signs were compared before and after treatment.
There were 39 patients who met inclusion criteria for analysis. Duration of symptoms before treatment was 80.8 ± 67.7 days. Following treatment, 19 (48.7%) patients reported complete pain resolution, 19 (48.7%) patients reported decreased pain permitting functional use, and 1 (2.6%) patient reported no improvement. All symptoms and signs decreased significantly following oral prednisone treatment ( < 0.001). Range of motion (ROM) deficits persisted in 19 (49%) patients. However, 17 of these patients reported functional ROM recovery. Degree of ROM recovery and time-to-treatment had low positive correlation ( = 0.354, < 0.001). Range of motion (ROM) deficits persisted in 19 (49%) patients. However, 17 of these patients reported functional ROM recovery. Degree of ROM recovery and time-to-treatment had low positive correlation (.
These data support short-course prednisone treatment for acute and subacute CRPS with multijoint involvement in a community rehabilitation setting. The association between time-to-treatment and ROM recovery suggests earlier treatment may result in improved ROM outcomes.
本研究的目的是在社区门诊康复环境中评估泼尼松对复杂性区域疼痛综合征（CRPS）特征的有效性。
采用单中心回顾性起始队列设计。纳入标准为根据布达佩斯标准诊断为CRPS、多关节受累、接受泼尼松治疗且症状持续时间少于一年。典型的泼尼松治疗是采用60毫克的28天递减方案。比较治疗前后患者的症状和体征。
有39名患者符合纳入分析标准。治疗前症状持续时间为80.8±67.7天。治疗后，19名（48.7%）患者报告疼痛完全缓解，19名（48.7%）患者报告疼痛减轻，可进行功能活动，1名（2.6%）患者报告无改善。口服泼尼松治疗后所有症状和体征均显著减轻（<0.001）。19名（49%）患者存在活动范围（ROM）缺陷。然而，其中17名患者报告功能ROM恢复。ROM恢复程度与治疗时间呈低度正相关（=0.354，<0.001）。19名（49%）患者存在活动范围（ROM）缺陷。然而，其中17名患者报告功能ROM恢复。ROM恢复程度与治疗时间呈低度正相关（。
这些数据支持在社区康复环境中对多关节受累的急性和亚急性CRPS进行短疗程泼尼松治疗。治疗时间与ROM恢复之间的关联表明，早期治疗可能会改善ROM结果。
