Abstract

Purpose

Complex regional pain syndrome (CRPS) is one of the common complications in stroke patients. Sympathetic dysfunction is usually considered underlying pathology. The evidence for contrast bath (CB) used in the treatment of CRPS is limited. The aim of the study is to investigate the possible effects of CB on the sympathetic activity in poststroke CRPS.

Materials and methods

Stroke patients with CRPS (CRPS group) and without CRPS (control group) were included in the study. Age, gender, duration of stroke, aetiology, plegic side, dominant hand, spasticity level, Brunnstrom stages, and comorbidities were recorded. CB was performed for one session to the plegic side of the CRPS and control groups. Sympathetic skin responses (SSR) was recorded from the plegic and healthy hands of participants at pre-CB and post-CB.

Results

Each group consisted of 20 participants. No significant difference was detected in stroke duration, aetiology, and Brunnstrom stages between groups. Elbow spasticity level was significantly higher in CRPS group (p = .034). SSR amplitudes of plegic hands were significantly decreased after CB in CRPS and control groups (p = .0002, p = .013 respectively). Also, CB reduced the SSR amplitude of healty side in CRPS group (p = .003). There was no statistically significant change in SSR latency or percentage changes of SSR amplitude and latency after CB in both groups.

Conclusion

CB leads to a significant reduction in sympathetic activity of plegic side of stroke patients. Also, CB to the plegic side has an inhibitory effect on sympathetic activity of healty side in poststroke CRPS. ClinicalTrials.gov ID: NCT04198532

中文翻译：

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对比浴对卒中后复杂区域疼痛综合征患者交感神经皮肤反应的急性影响

摘要

目的

复杂区域疼痛综合征（CRPS）是脑卒中患者常见的并发症之一。交感神经功能障碍通常被认为是潜在的病理学。用于治疗 CRPS 的造影剂浴 (CB) 的证据有限。该研究的目的是调查 CB 对中风后 CRPS 交感神经活动的可能影响。

材料和方法

研究中包括患有 CRPS（CRPS 组）和没有 CRPS（对照组）的中风患者。记录年龄、性别、中风持续时间、病因、麻痹侧、惯用手、痉挛程度、Brunnstrom 阶段和合并症。CB 对 CRPS 组和对照组的瘫痪侧进行了一次治疗。在 CB 前和 CB 后，参与者的麻痹和健康手记录了交感皮肤反应 (SSR)。

结果

每组由20名参与者组成。两组间卒中持续时间、病因和布伦斯特伦分期没有显着差异。CRPS 组的肘部痉挛水平明显更高（p = .034）。在 CRPS 和对照组中，CB 后瘫痪手的 SSR 幅度显着降低（分别为 p = .0002，p = .013）。此外，CB 降低了 CRPS 组健康侧的 SSR 幅度（p = .003）。两组的SSR潜伏期或CB后SSR幅度和潜伏期的百分比变化均无统计学意义。

结论

CB导致中风患者麻痹侧的交感神经活动显着降低。此外，麻痹侧的CB对卒中后CRPS中健康侧的交感神经活动具有抑制作用。ClinicalTrials.gov ID： NCT04198532