Somatosensory rehabilitation for allodynia in complex regional pain syndrome of the upper limb: A retrospective cohort study

Packham, Tara; Spicher, Claude J.; MacDermid, Joy C.; Michlovitz, Susan; Buckley, D. Norman

doi:10.1016/j.jht.2017.02.007

Cited by 21 publications

(15 citation statements)

References 44 publications

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“…The Somatosensory Rehabilitation Method (SRM) has been proposed as a nonpharmacological treatment for neuropathic pain, including allodynia [11]. It uses the principles of somatosensory re-education through targeted comfortable sensory stimulation (e.g., mindful perception of the different textures and temperatures of materials, and the dynamics and intensity of the application of the stimulus) based on contemporary understandings of the function and dysfunction of the somatosensory system [12].…”

Section: Introductionmentioning

confidence: 99%

Allodynography: Reliability of a New Procedure for Objective Clinical Examination of Static Mechanical Allodynia

et al. 2019

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Objective There is a need for reliable and valid clinical assessment tools for quantifying allodynia in neuropathic pain. Allodynography has been proposed as a useful standardized procedure for clinical assessment of mechanical allodynia. This study (www.clinicaltrials.gov NCT02070367) undertook preliminary investigation of the measurement properties of allodynography, a new standardized clinical examination procedure for mapping the area of cutaneous allodynia. Methods Persons with pain in one upper extremity after complex regional pain syndrome, a peripheral nerve injury, or who had recently experienced a hand fracture were recruited for assessment of static mechanical allodynia (based on perception of a 15g force stimulus delivered by Semmes-Weinstein monofilament #5.18 as painful) by two raters at baseline; the assessment was repeated one week later. Results Single-measures estimates suggested inter-rater reliability for allodynography was excellent at an intraclass correlation coefficient (ICC) of 0.97 (N = 12); test–retest reliability was also excellent at ICC = 0.89 (N = 10) for allodynography (P < 0.001 for both). Confidence intervals’ lower bounds confirm inter-rater reliability as excellent (0.90) but were less definitive for test–retest (0.59). Conclusions This preliminary study supports the inter-rater and test–retest reliability of allodynography. Studies on larger samples in multiple contexts and reporting other measurement properties are warranted.

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Section: Introductionmentioning

confidence: 99%

Allodynography: Reliability of a New Procedure for Objective Clinical Examination of Static Mechanical Allodynia

et al. 2019

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“…Both standardised clinical evaluations address unique aspects of the positive sensory phenomenon of static mechanical allodynia not quantified by standard electrophysiological testing (Yarnitsky and Pud 2004;Backonja et al 2013). They make use of sensory evaluation equipment, and support the standardised evaluation of persistent and/or neuropathic pain (Walk et al 2009;Haanp€ a€ a et al 2011;Uddin and MacDermid 2016) and can inform the planning of sensory reeducation treatments such as somatosensory rehabilitation (Packham et al 2018). One final point should be made on the novelty of the rainbow pain scale as a clinical examination sign: it can only be considered relatively novel in humans.…”

Section: Discussionmentioning

confidence: 99%

“…The McGill Pain Questionnaire (MPQ) is used in conjunction with the clinical examination signs of allodynography and the rainbow pain scale for outcome measurement within the somatosensory rehabilitation method (Melzack 2005) although most of the studies published to date use the French language version (Nedelec et al 2016;Packham et al 2018). While our goal for this investigation was not to measure outcomes, we thought it important to include a familiar measure of pain qualities to describe the population.…”

Section: Evaluation Of Pain Qualitiesmentioning

confidence: 99%

Evaluating a sensitive issue: reliability of a clinical evaluation for allodynia severity

Packham

Spicher

MacDermid

et al. 2019

Somatosensory & Motor Research

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Purpose/Aim: Allodynia is a common feature of neuropathic pain with few validated clinical evaluation options. We identified a need to estimate the measurement properties of the standardised evaluation procedure for static mechanical allodynia severity popularised by the somatosensory rehabilitation of pain method, known as the rainbow pain scale. This study (www.clinicaltrials.gov. NCT02070367) undertook preliminary investigation of the inter-rater and test-retest reliability of the rainbow pain scale. Methods: Persons with pain in one upper extremity after Complex Regional Pain Syndrome, a peripheral nerve injury or a recent hand fracture were recruited for assessment of static mechanical allodynia threshold using calibrated monofilaments by two raters at baseline, and repeated assessment one week later. Results: Single measures estimates suggested inter-rater reliability was substantial for the rainbow pain scale [intra-class correlation coefficient ¼ 0.78 (n ¼ 31), p < 0.001]. Test-retest reliability was also excellent at with an intraclass correlation coefficient of 0.87 [n ¼ 28, p < 0.001]. However, confidence intervals suggest the true values could be more moderate, with lower bounds of the 95% confidence interval at 0.60 and 0.74, respectively. Conclusions: This pilot study has generated preliminary support for the inter-rater and test-retest reliability of the rainbow pain scale. Future studies should seek to increase confidence in estimates of reliability, and estimate validity and responsiveness to change in persons with somatosensory disorders.

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“…Andere Studien zum CRPS (mit kleinen Fallserien, unkontrollierten Kohorten oder Cross-over-Designs [24][25][26][27]) setzen nicht ausschließlich traditionelles Sensibilitätstraining ein, beleuchten aber interessante Aspekte. Gemäß den dort vorgeschlagenen Definitionen ist taktiles Diskriminationstraining ein Hybrid-Ansatz mit Elementen der Desensibilisierung und des Sensibilitätstrainings.…”

Section: Insgesamt Gibt Es Keine Qualitativ Hochwertige Evidenz Für Dieunclassified

Desensibilisierung oder Sensibilitätstraining?

Packham¹,

Meyer²

2021

Praxis Handreha

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Handtherapeuten begegnen sensiblen Störungen mit Sensibilitätstraining oder Desensibilisierungstechniken. Doch oft sind sowohl die Begrifflichkeiten als auch die entsprechenden Behandlungsmaßnahmen nicht klar voneinander abgegrenzt. Tara Packham erklärt die Unterschiede, prüft kritisch die vorhandene Evidenz und schlägt schließlich einen Algorithmus für die Behandlung dieser Störungen vor.

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Somatosensory rehabilitation for allodynia in complex regional pain syndrome of the upper limb: A retrospective cohort study

Cited by 21 publications

References 44 publications

Allodynography: Reliability of a New Procedure for Objective Clinical Examination of Static Mechanical Allodynia

Allodynography: Reliability of a New Procedure for Objective Clinical Examination of Static Mechanical Allodynia

Evaluating a sensitive issue: reliability of a clinical evaluation for allodynia severity

Desensibilisierung oder Sensibilitätstraining?

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