Complex Regional Pain Type 1

Occupational therapy treatment of complex regional pain syndrome in children and adolescents: a scoping review protocol

OBJECTIVE

This scoping review will explore the literature related to occupational therapy interventions and delivery methods for pediatric complex regional pain syndrome.

INTRODUCTION

Complex regional pain syndrome is a debilitating pain condition that is becoming increasingly diagnosed within the pediatric population. Untreated, it can negatively impact a child's occupational engagement and participation, social functioning, and family dynamics. A multidisciplinary treatment approach is typically recommended, with occupational therapy as an essential component. Occupational therapy interventions for pediatric complex regional pain syndrome usually promote a child's ability to participate in daily activities to prevent further impairment and disability. Despite evidence that occupational therapy practitioners treat this population, no review has been conducted of the available literature on occupational therapy interventions for pediatric complex regional pain syndrome.

INCLUSION CRITERIA

This review will consider studies that include any form of occupational therapy interventions for participants with complex regional pain syndrome who are 18 years or younger. Quantitative, qualitative, and observational studies, and text and opinion papers will be considered.

METHODS

The JBI methodology will be used to conduct this scoping review. MEDLINE, Embase, Scopus, APA PsycINFO, CINAHL, OTDBASE, OT Search (AOTA), OTseeker, and ProQuest Dissertations and Theses Global will be searched for studies in English, with no limit on publication date. Two independent reviewers will screen the titles, abstracts, and full texts of the selected studies. Data collection will be performed using a tool developed by the researchers based on the standardized JBI tool. Data will be presented in a comprehensive narrative summary.

Successful Multimodal Treatment for Complex Regional Pain Syndrome in an Adolescent with Acute Lymphoblastic Leukemia: A Case Report

Complex regional pain syndrome (CRPS) is a debilitating disorder that causes significant pain and can decrease the quality of life of affected individuals. This is the first report of CRPS in an adolescent oncology patient, whose symptoms successfully resolved with 3 weeks of intensive, multimodal, and multidisciplinary therapies. She experienced a complete return to pre-CRPS functional status within 10 weeks. The successful outcome of this case highlights the importance of early recognition of CRPS in the adolescent population and the need for a multimodal intensive treatment regimen to prevent the development of chronic pain and loss of limb function.

Treatment of Complex Regional Pain Syndrome in Children and Adolescents: A Structured Literature Scoping Review

Background: Complex regional pain syndrome (CRPS) is characterized by chronic, spontaneous and provoked pain of the distal extremities whose severity is disproportionate to the triggering event. Diagnosis and treatment are still debated and multidisciplinary. The purpose of this systematic review is to analyze the available literature to provide an update on the latest evidence related to the treatment of CRPS in growing age. Methods: Data extraction was performed independently by three reviewers based on predefined criteria and the methodologic quality of included studies was quantified by the Newcastle–Ottawa Quality Assessment Scale Cohort Studies. Results: At the end of the first screening, following the previously described selection criteria, we selected n = 103 articles eligible for full-text reading. Ultimately, after full-text reading and a reference list check, we selected n = 6. The articles focused on physical (PT), associated with cognitive behavioral (CBT) and pharmacological (PhT) treatments. The combination of PT + CBT shows the most efficacy as suggested, but a commonly accepted protocol has not been developed. Conclusions: Physical therapy in association with occupational and cognitive behavioral treatment is the recommended option in the management of pediatric CPRS. Pharmacological therapy should be reserved for refractory and selected patients. The design and development of a standard protocol are strongly suggested.