University Hospital Würzburg Department of Anaesthesiology Intensive Care, Emergency and Pain Medicine Centre for Interdisciplinary Pain Medicine, Würzburg, Germany.
University Hospital of Mainz Department of Neurology, Mainz, Germany.
Pain Res Manag. 2024 Aug 24;2024:9993438. doi: 10.1155/2024/9993438. eCollection 2024.
Complex regional pain syndrome (CRPS) represents a rare complication following injury to a limb. The DASH questionnaire (disability of arm, shoulder, and hand) evaluates everyday arm function. We assessed the DASH and its subitems in comparison to patients with brachial plexus lesions or fracture controls, analysed it over time, and in relation to active range of motion (ROM), to determine patients' impairment and trajectory.
The dataset included 193 patients with upper extremity CRPS from the noncoding RNA (ncRNA) Pain cohort, 36 fracture controls, and 12 patients with traumatic brachial plexus lesions. For the clinical and psychological characterisation, questionnaires and a goniometer for the measurement of ROM were utilized. Thirty-three patients were followed up after approximately 2.5 years of guideline treatment.
CRPS patients had a similar mean DASH of 54.7 (standard deviation (S.D.) ±21) as brachial plexus lesion patients ( = 51.4, S.D. ± 16.1) but different significantly from fracture controls ( = 21.2, S.D. ± 21.1). Pain and older age were predictors of the DASH. Activities requiring force or impact on the arm, shoulder, or hand were mostly affected in patients with CRPS. After 2.5 years of standard treatment, the mean DASH score fell to 41.3 (S.D. ± 25.2), weakness in leisure activities was recuperated, pain feelings were lessened, and ROM, e.g., wrist flexion, recovered by 36°. Two-thirds of patients improved in both the DASH and the ROM.
CRPS is as disabling as a complete loss of arm function in brachial plexus lesions and exhibits only partial recovery. Developing QuickDASH versions for CRPS patients could reduce the load of questions in clinical studies. It would be prudent to consider the unexpected age dependency of the DASH in future studies. This trial is registered with DRKS00008964.
复杂性区域疼痛综合征（CRPS）是肢体损伤后罕见的并发症。DASH 问卷（手臂、肩膀和手的残疾）评估日常手臂功能。我们比较了 DASH 及其子项与臂丛损伤或骨折对照组，分析了随时间的变化，并与主动关节活动度（ROM）相关，以确定患者的损伤和轨迹。
数据集包括来自非编码 RNA（ncRNA）疼痛队列的 193 例上肢 CRPS 患者、36 例骨折对照组和 12 例创伤性臂丛损伤患者。为了进行临床和心理特征分析，使用了问卷和测角器来测量 ROM。33 例患者在接受大约 2.5 年的指南治疗后进行了随访。
CRPS 患者的平均 DASH 为 54.7（标准差（SD）±21），与臂丛损伤患者（ = 51.4，SD ± 16.1）相似，但与骨折对照组（ = 21.2，SD ± 21.1）有显著差异。疼痛和年龄较大是 DASH 的预测因素。需要用力或对手臂、肩膀或手产生冲击的活动在 CRPS 患者中受影响最大。经过 2.5 年的标准治疗，平均 DASH 评分降至 41.3（SD ± 25.2），休闲活动中的无力感得到恢复，疼痛减轻，ROM，例如腕关节屈曲，恢复了 36°。三分之二的患者在 DASH 和 ROM 方面都有改善。
CRPS 与臂丛损伤完全丧失手臂功能一样具有致残性，且仅部分恢复。为 CRPS 患者开发 QuickDASH 版本可以减少临床研究中的问题负担。在未来的研究中，考虑 DASH 的意外年龄依赖性是明智的。本试验在 DRKS00008964 注册。
