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The DOI matches its Crossref record; 45 of the 45 references it cites were found in a registry or an index.

Pain exposure physical therapy (PEPT) compared to conventional treatment in complex regional pain syndrome type 1: a randomised controlled trial

Open access
Barnhoorn, Karlijn J, van de Meent, Henk, van Dongen, Robert T M, Klomp, Frank P, Groenewoud, Hans, Samwel, Han, Nijhuis-van der Sanden, Maria W G, Frölke, Jan Paul M, Staal, J Bart·2015·BMJ Open
DOI 10.1136/bmjopen-2015-008283PMC PMC4679993
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Abstract

Objective: To compare the effectiveness of pain exposure physical therapy (PEPT) with conventional treatment in patients with complex regional pain syndrome type 1 (CRPS-1) in a randomised controlled trial with a blinded assessor. Setting: The study was conducted at a level 1 trauma centre in the Netherlands. Participants: 56 adult patients with CRPS-1 participated. Three patients were lost to follow-up. Interventions: Patients received either PEPT in a maximum of five treatment sessions, or conventional treatment following the Dutch multidisciplinary guideline. Measurements: Outcomes were assessed at baseline and at 3, 6 and 9 months after randomisation. The primary outcome measure was the Impairment level Sum Score—Restricted Version (ISS-RV), consisting of visual analogue scale for pain (VAS-pain), McGill Pain Questionnaire, active range of motion (AROM) and skin temperature. Secondary outcome measures included Pain Disability Index (PDI); muscle strength; Short Form 36 (SF-36); disability of arm, shoulder and hand; Lower Limb Tasks Questionnaire (LLTQ); 10 m walk test; timed up-and-go test (TUG) and EuroQol-5D. Results: The intention-to-treat analysis showed a clinically relevant decrease in ISS-RV (6.7 points for PEPT and 6.2 points for conventional treatment), but the between-group difference was not significant (0.96, 95% CI −1.56 to 3.48). Participants allocated to PEPT experienced a greater improvement in AROM (between-group difference 0.51, 95% CI 0.07 to 0.94; p=0.02). The per protocol analysis showed larger and significant between-group effects on ISS-RV, VAS-pain, AROM, PDI, SF-36, LLTQ and TUG. Conclusions: We cannot conclude that PEPT is superior to conventional treatment for patients with CRPS-1. Further high-quality research on the effects of PEPT is warranted given the potential effects as indicated by the per protocol analysis. Trial registration numbers: NCT00817128 and NTR 2090.

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  • Recently, pain exposure physical therapy has been shown to be similar or superior to conventional treatments in CRPS patients.

    “Recently, pain exposure physical therapy has been shown to be similar or superior to conventional treatments in CRPS patients [32, 33].”

    From Symptom reduction and improved function in chronic CRPS type 1 after 12-week integrated, interdisciplinary therapy (2019) · cites this paper as [32]

    The Abstract Results and Discussion report no significant between-group difference on the primary outcome in the intention-to-treat analysis, a greater improvement in active range of motion with PEPT, and significant advantages on several outcomes in the per-protocol analysis. The paper explicitly says it cannot conclude that PEPT is superior to conventional treatment; a nonsignificant difference also does not establish equivalence. The claim therefore overstates what was shown. (LLM, conf=0.86)

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Metadata

Authors
Barnhoorn, K. J., van de Meent, H., van Dongen, R. T. M., Klomp, F. P., Groenewoud, H., Samwel, H., Nijhuis-van der Sanden, M. W. G., Frölke, J. P. M., & Staal, J. B.
Affiliations
  • Radboud University Medical Center (NL)
  • HAN University of Applied Sciences (NL)
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2015-12
Volume
5
Issue
12
Pages
e008283
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2015-008283
PMC
PMC4679993
OpenAlex
W2181591943
Cited by
77
References
45
Citations by year
2026: 2 · 2025: 5 · 2024: 4 · 2023: 8 · 2022: 11 · 2021: 10 · 2020: 7 · 2019: 9 · 2018: 10 · 2017: 5 · 2016: 5 · 2015: 1
FWCI
9.13
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion, other-oa)
Funders
ZonMw (170991004)
Topics
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Keywords
complex regional pain syndrome type I, conventional therapy, range of motion, pain-related disability, functional disability, multidisciplinary treatment
MeSH terms
Adult, Female, Humans, Male, Middle Aged, Pain Measurement, Patient Compliance, Prospective Studies, Single-Blind Method, Treatment Outcome, Complex Regional Pain Syndromes, Physical Therapy Modalities, Intention to Treat Analysis

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