Geertzen J H, Dijkstra P U, van Sonderen E L, Groothoff J W, ten Duis H J, Eisma W H
Department of Rehabilitation, University Hospital Groningen, The Netherlands.
Clin Rehabil. 1998 Oct;12(5):402-12. doi: 10.1191/026921598676761735.
To determine the relationship between impairments, disability and handicap in reflex sympathetic dystrophy (RSD) patients.
A long-term follow-up study of upper extremity RSD patients.
A university hospital.
Sixty-five patients, 3-9 years (mean interval 5.5 years) after RSD of the upper extremity (mean age 50.2 years).
Impairments: range of motion, moving two point discrimination, muscle strength of the hand and pain were measured. Disability was assessed with the Groningen Activity Restriction Scale (GARS) and handicap was assessed with three subscales (social functioning, role limitations due to physical problems and role limitations due to emotional problems) of the RAND-36.
After RSD of the upper extremity, 62% of the patients are limited in activities of daily living (ADL) and/or instrumental ADL (IADL). Pain and restrictions in forward flexion of the shoulder, thumb opposition and grip strength are the most important impairments limiting ADL and IADL. Patients with limitations in ADL and IADL are significantly more handicapped than patients without limitations. Pain is the most important factor contributing to handicap.
The relationship between impairments and disability and between disability and handicap in RSD patients is weak to moderate. Pain is the most important factor leading to disability and handicap.
确定反射性交感神经营养不良（RSD）患者的损伤、残疾和残障之间的关系。
对上肢RSD患者进行长期随访研究。
一家大学医院。
65例上肢RSD患者，发病后3 - 9年（平均间隔5.5年），平均年龄50.2岁。
测量损伤情况，包括活动范围、两点辨别觉、手部肌肉力量和疼痛。采用格罗宁根活动受限量表（GARS）评估残疾情况，采用兰德36项健康调查简表（RAND - 36）的三个分量表（社会功能、因身体问题导致的角色限制和因情感问题导致的角色限制）评估残障情况。
上肢RSD发病后，62%的患者在日常生活活动（ADL）和/或工具性日常生活活动（IADL）方面受到限制。疼痛以及肩部前屈、拇指对掌和握力受限是限制ADL和IADL的最重要损伤因素。ADL和IADL受限的患者比未受限的患者残障程度明显更严重。疼痛是导致残障的最重要因素。
RSD患者的损伤与残疾之间以及残疾与残障之间的关系为弱到中度。疼痛是导致残疾和残障的最重要因素。
