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Graded Exposure (GEXP) in Vivo Versus Physiotherapy in Complex Regional Pain Syndrome Type I (CRPS-I)

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT00625976
First Posted: February 29, 2008
Last Update Posted: September 19, 2014
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by (Responsible Party):
Maastricht University Medical Center
  Purpose

Background:

Research on the treatment of CRPS-I, as described in the Dutch evidence based treatment guidelines (Richtlijn Complex Regional Pain Syndrome type I, 2006), mainly showed improvement at the level of pain and coping with pain. Only little improvement in functional restoration was found. Research in other pain populations such al neck- and back-pain patients has shown that pain related fear contributes to the development of functional disability. GEXP in vivo which aims on systematically reducing fear of movement, shows promising results in CRPS-I patients (de Jong et al., 2005).

Objective:

The objective of the proposed project is to compare the effectivity of GEXP in vivo with that of standardized physiotherapy in CRPS-I patients with pain related fear.

Design:

The study concerns a single blinded, single center, randomized clinical trial. The treatment will be preceded by two pre-measures. After treatment there will be one post-measurement and 3, 6 and 12 month follow-up measurements.

Population:

The study population will consist of chronic CRPS-I patients between 18 and 65, with pain related fear (PHODA-LE-score ≥ 35 and PHODA-UE-score ≥ 32).

Intervention:

The two interventions that will be compared are GEXP in vivo (de Jong et al., 2005) and standardized physiotherapy according to the protocol of Oerlemans, Oostendorp, de Boo en Goris (1999). The GEXP in vivo comprises 17 sessions of one hour, the physiotherapy treatment of 34 sessions of 30 minutes. Both treatments will be given over a period of 17 weeks.


Condition Intervention
Complex Regional Pain Syndrome Type I Behavioral: Graded exposure in vivo Behavioral: Physiotherapy

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: The Effectivity of Graded Exposure in Vivo Versus Standardized Physiotherapy in Complex Regional Pain Syndrome Type I (CRPS-I) Patients With Pain Related Fear: a Randomized Clinical Trial

Resource links provided by NLM:


Further study details as provided by Maastricht University Medical Center:

Primary Outcome Measures:
  • Functional disability measured with: Radboud Skills Questionnaire (RASQ; Oerlemans, Cup et al., 2000), for upper limbs; Walking Ability Questionnaire (WAQ; Perez et al., 2002), for lower limbs [ Time Frame: 2 times pre treatment, one time post treatment and at 3, 6 and 12 months follow-up ]

Secondary Outcome Measures:
  • Physical activity in daily life [ Time Frame: 2 times pre treatment, one time post treatment and at 3, 6 and 12 months follow-up ]
  • Body function and structure [ Time Frame: 2 times pre treatment, one time post treatment and at 3, 6 and 12 months follow-up ]
  • Fear of movement [ Time Frame: 2 times pre treatment, one time post treatment and at 3, 6 and 12 months follow-up ]
  • Fear of pain [ Time Frame: 2 times pre treatment, one time post treatment and at 3, 6 and 12 months follow-up ]
  • Catastrophizing Scale [ Time Frame: 2 times pre treatment, one time post treatment and at 3, 6 and 12 months follow-up ]
  • Coping with pain [ Time Frame: 2 times pre treatment, one time post treatment and at 3, 6 and 12 months follow-up ]
  • Emotional distress [ Time Frame: 2 times pre treatment, one time post treatment and at 3, 6 and 12 months follow-up ]
  • Participation [ Time Frame: 2 times pre treatment, one time post treatment and at 3, 6 and 12 months follow-up ]
  • Emotional involvement [ Time Frame: 2 times pre treatment, one time post treatment and at 3, 6 and 12 months follow-up ]

Enrollment: 46
Study Start Date: May 2008
Study Completion Date: September 2014
Primary Completion Date: December 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1 Behavioral: Graded exposure in vivo
Graded exposure in vivo according to the protocol of de Jong et al. (2005)
Experimental: 2 Behavioral: Physiotherapy
Physiotherapy according to the protocol of Oerlemans, Oostendorp, de Boo and Goris (1999)

  Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Diagnosis CRPS-I according to IASP criteria.
  2. Pain related (PHODA-LE-score ≥ 35 and PHODA-UE-score ≥ 32)
  3. Age between 18 and 65.
  4. Rehabilitation treatment has been indicated.

Exclusion Criteria:

  1. Pregnancy.
  2. Insufficient fluency in Dutch.
  3. Generalized pain syndrome.
  4. Dystonia.
  5. Sympathectomy of the affected extremity.
  6. Psychopathology
  7. Involvement in a claim regarding the disease.
  8. Substance abuse.
  9. Symptoms on both upper or both lower extremities.
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00625976


Sponsors and Collaborators
Maastricht University Medical Center
Investigators
Principal Investigator: Marielle Goossens, Dr. Maastricht University
  More Information

Responsible Party: Maastricht University Medical Center
ClinicalTrials.gov Identifier: NCT00625976     History of Changes
Other Study ID Numbers: MEC 08-3-004
NL20067.068.08
First Submitted: February 21, 2008
First Posted: February 29, 2008
Last Update Posted: September 19, 2014
Last Verified: September 2014

Keywords provided by Maastricht University Medical Center:
Complex regional pain syndrome type I
Graded exposure in vivo
Physiotherapy
Pain-related fear

Additional relevant MeSH terms:
Syndrome
Somatoform Disorders
Complex Regional Pain Syndromes
Reflex Sympathetic Dystrophy
Disease
Pathologic Processes
Mental Disorders
Autonomic Nervous System Diseases
Nervous System Diseases
Peripheral Nervous System Diseases
Neuromuscular Diseases