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Sensorimotor dysfunction after limb fracture - An exploratory study
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DOI：10.1002/ejp.863.png)
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Abstract
En 中文
BackgroundChronic pain is often associated with sensorimotor dysfunction but little is known about the early impact of limb fracture on sensory and motor performance. This exploratory study sought to assess these changes in patients with recent wrist and ankle fractures. A secondary aim was to determine the incidence of Complex Regional Pain Syndrome (CRPS) and its clinical features. MethodsFifty-three patients at a UK fracture centre underwent Quantitative Sensory Testing (QST), Motor Imagery (MI) and Body Perception Disturbance (BPD) assessments 5weeks post-fracture (Time 1). Subjective evaluation of recovery and clinical examination for CRPS was conducted 5weeks later (Time 2, 50 patients). Patient-reported outcomes of pain, psychological distress and limb function were collected at Times 1 and 2, and 6months after T1 (Time 3, 36 patients, postal questionnaire). ResultsQuantitative sensory testing at Time 1 demonstrated cold and pressure-pain hyperalgesia in the fractured limb compared to the non-fractured side (p<0.05). Imagined movements were reported as significantly more difficult to perform on the fractured side (p<0.001). There was evidence of BPD in the fractured limb, similar to that found in CRPS. The incidence of CRPS was 9.4%; however, individual signs and symptoms of the condition were commonly present (70% reported one symptom). Only 33% of patients reported to being back to normal' 6months after fracture with 34% reporting ongoing pain. ConclusionsLimb fracture is associated with changes in pain perceptions, motor planning, and disruption to body perception. Signs and symptoms of CRPS, ongoing pain and delayed recovery post-fracture are common. What does this study add?In the immediate post-fracture period: Body perception disturbance is reported in the fractured limb. Imagined movements of the fractured limb are less vivid and associated with pain This study contributes to the incidence literature on CRPS.
Keywords:
COMPLEX REGIONAL PAIN
SYNDROME TYPE-I
NEGLECT-LIKE SYMPTOMS
CORTICAL REORGANIZATION
DISTAL RADIUS
MOTOR IMAGERY
ABNORMALITIES
ALGODYSTROPHY
POPULATION
PERCEPTION
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