Comparison of Short-Term Effect between Bisphosphonate and Steroid Therapy in Hemiplegic Patients with CRPS Type I.
- Author:
Geun Young PARK
1
;
Joo Hyun PARK
;
Bena LEE
;
Sun IM
;
Ji Hye MIN
Author Information
1. Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Korea. lafolia@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Complex regional pain syndrome;
Pamidronate;
Steroids;
Hemiplegia;
Reflex sympathetic dystrophy
- MeSH:
Comorbidity;
Diphosphonates;
Hand;
Hemiplegia;
Humans;
Reflex Sympathetic Dystrophy;
Steroids;
Wrist
- From:Journal of the Korean Academy of Rehabilitation Medicine
2009;33(1):103-107
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To determine the effects of the antiresorptive agent bisphosphonate in hemiplegic patients with CRPS and to compare its effects to standard steroid pulse therapy. METHOD: Thirteen randomly selected hemiplegic patients diagnosed with CRPS received bisphosphonate therapy which consisted of intravenous pamidronate injection of a total cumulative dose of 180 mg in one week. Eleven hemiplegic patients with CRPS received the standard 2-week steroid pulse therapy. Clinical assessments were made for temperature, pain score, volumetry and circumference of both the third digit and wrist. All assessments were carried out twice; before the initiation of therapy and two weeks after pamidronate or steroid therapy. RESULTS: The steroid group showed statistical improvement in pain (p=0.039), total hand volume(p=0.006) wrist (p= 0.007) and 3rd digit (p=0.003) circumference. The pamidronate group showed statistical improvement in pain (p=0.011), wrist (p=0.043) and 3rd digit (p=0.021) circumference; however no statistical improvement was observed in total hand volume (p=0.767). Neither group showed any statistical significance in temperature change. CONCLUSION: Pamidronate therapy may be an alternative method in managing CRPS in hemiplegic patients with multiple medical comorbidities who are not eligible to receive the conventional steroid therapy.
