Effectiveness of contrast compression therapy for post-stroke complex regional pain syndrome: a randomized control...

Complex regional pain syndrome (CRPS) is a frequent complication after stroke that negatively impacts pain, function, and rehabilitation outcomes.

This study aimed to assess the effectiveness of additional contrast compression therapy combined with conventional rehabilitation on edema, pain, function, motor recovery, and spasticity in post-stroke CRPS.

This prospective, assessor-blind randomized controlled trial was conducted at the inpatient stroke rehabilitation clinic. Seventy-two patients with upper extremity CRPS type-I in the subacute stage after a first-ever stroke were randomly assigned to an experimental or control group. Both groups underwent a standardized conventional rehabilitation program 5-day/week, 3-hours/day for 4 weeks, including positioning, range of motion, stretching, strengthening, and transcutaneous electrical nerve stimulation. The experimental group additionally received contrast compression therapy once daily 15-minutes/session for 10 days. Outcomes were edema (water displacement), rest and activity-related pain (Visual Analog Scale), neuropathic pain (painDETECT Questionnaire), functional status (Functional Independence Measure-Motor), motor recovery (Brunnstrom Stages), and spasticity (Modified Ashworth Scale) assessed at baseline and post-treatment 4 weeks.

Both groups showed significant improvements in all outcomes (p < .05). The experimental group demonstrated significantly greater reductions in edema volume and activity-related pain than the control group (p < .001 and p = .001, respectively). No between-group differences were observed in neuropathic pain, functional status, motor recovery, and spasticity.

Contrast compression therapy provided superior short-term benefits for reducing upper extremity edema and activity-related pain when added to conventional rehabilitation in post-stroke CRPS. It may serve as an effective non-pharmacologic adjunct in stroke rehabilitation.Clinical Trial Registration: NCT07062913.