‘‘Pain exposure’’ physical therapy (PEPT) is a new treatment for patients with complex regional pain syndrome
type 1 (CRPS-1) that consists of a progressive-loading exercise program and management of painavoidance
behavior without the use of specific CRPS-1 medication or analgesics. The aim of this study
was to investigate primarily whether PEPT could be applied safely in patients with CRPS-1. Twenty
patients with CRPS-1 were consecutively enrolled in the study after giving informed consent. The diagnosis
of CRPS-1 was defined using the Bruehl and Harden/IASP diagnostic criteria. CRPS-1 was diagnosed
between 3 and 18 months after the inciting event (trauma). According to a multiple single-case design
(baseline [A1], treatment [B], follow-up [A2]), multiple baseline and follow-up measurements were performed
to evaluate changes in CRPS signs and symptoms and to assess functional parameters. When comparing
the baseline with the follow-up phase, patients improved significantly with respect to pain on the
visual analogue scale (57%), pain intensity (48%), muscle strength (52%), arm/shoulder/hand disability
(36%), 10-meter walking speed (29%), pain disability index (60%), kinesiophobia (18%), and the domains
of perceived health change in the SF-36 survey (269%). Three patients initially showed increased vegetative
signs but improved in all other CRPS parameters and showed good functional recovery at follow-up.
We conclude that PEPT is a safe and effective treatment for patients with CRPS-1.