Thesis (Ph.D.) - Cairo University - Faculty of Physical Therapy - Department of Basic Science

Background: Complex regional pain syndrome type I is a chronic condition; there is disturbances in the sympathetic, somatosensory and motor nervous system, resulting in severe pain and disability. Purpose: To investigate the effect of thoracic manipulation on pain, functional disability, edema, bone mineral density, and range of motion in patients with Complex regional pain syndrome type I post-upper limb trauma. Patients and Methods: Thirty patients with complex regional pain syndrome type I (10-18 weeks duration of illness) were randomly distributed into two equal groups (15 for each group), control group (A) and experimental group (B).The mean age of groups (A and B) was (52±6.7) and (51.2±6.6) years respectively. Group (A) was treated by traditional treatment which consisted of Transcutaneous Electrical Neuromuscular Stimulation, desensitization, mirror therapy, massage, and exercises.Group (B) was treated by traditional treatment as group (A) and thoracic spinal manipulation. Treatment was given 3 times per week, for 12 weeks. Patients were evaluated before and after treatment for pain severity using vasual analogue scale, functional disability using Disability of Arm, Shoulder, and Hand questionnair, edema using tape measurement, bone mineral density using Dual-energy X-ray absorptiometry, range of motion using universal goniometer and opposition using ruler measurement. Results: Both groups showed statistically significant improvement in all the measured variables except in edema for group (A) within groups. However, improvement between groups was statistically significant in function (P=0.001), edema (P=0.038), shoulder range of motions (flexion, abduction and rotations) (P=0.001) favor in group (B) but statistically non-significant in pain at rest (P=0.098) and with brush (P=0.39), bone mineral density (P=0.257) and range of motions of shoulder Extension, elbow, wrist, metacarpophalangeal and interphalangeal joints (P>0.05)

Issued also as CD