Sensory training system for use at home by people with complex regional pain syndrome in England: protocol for a proof-of-concept study

Introduction Complex regional pain syndrome (CRPS) is a disabling and distressing chronic pain condition characterised by a range of sensory, motor, autonomic and trophic symptoms. UK guidelines recommend therapy interventions to help normalise touch perception through self-administered tactile and thermal desensitisation activities. Interventions have been developed, aiming to help individuals broaden their sensory experience, thereby relieving chronic pain. However, therapy-led interventions often experience practical constraints and poor adherence. In response, a sensory training system (STS) device has been designed for unsupervised independent home-use. Methods This proof-of-concept study aims to explore whether people with CRPS use the device at home for 30 minutes a day for 30 days. Secondary aims are to determine whether the STS device will change tactile acuity and perceived levels of pain intensity, pain interference, sensitivity or feelings towards the affected limb. We will seek to recruit 20 eligible participants. Participants will be asked to measure tactile acuity using a two-point discrimination assessment, complete an online questionnaire before and after use of the device and complete a daily diary. On completion of the 30-day use, participants will be invited to take part in a semi-structured interview to explore their experiences of using the device. Analysis Pain intensity and pain interference will be scored using the online Assessment Center Scoring Service or using the look-up table in the PROMIS scoring manual. The remaining questionnaire data, including tactile acuity results, and device-use data, including frequency and duration of use, will be analysed using descriptive statistics. Qualitative data will be thematically analysed. Ethics and dissemination London-Stanmore Research Ethics Committee provided a favourable opinion on 19 April 2021 (ref 21/LO/0200). The NHS Health Research Authority, UK, approved this study on 7 June 2021. Dissemination will include peer-reviewed publications, presentations at conferences, social media and reports to the funder and patient charities. Trial registration number ISRCTN89099843.

[1]  N. Dardenne,et al.  Feasibility and Acceptability of a Home-Based Sensory Perception Training Game for Patients with Fibromyalgia: A Pilot Study. , 2022, Games for health journal.

[2]  G. Moseley,et al.  Effect of Graded Sensorimotor Retraining on Pain Intensity in Patients With Chronic Low Back Pain: A Randomized Clinical Trial. , 2022, JAMA.

[3]  Amos S Hundert,et al.  Screening and diagnostic tools for complex regional pain syndrome: a systematic review , 2020, Pain.

[4]  F. Luthi,et al.  Direct Health Care Cost and Work Incapacity Related to Complex Regional Pain Syndrome in Switzerland: A Retrospective Analysis from 2008 to 2015. , 2019, Pain medicine.

[5]  W. Adamczyk,et al.  Tactile acuity (dys)function in acute nociceptive low back pain: a double-blind experiment , 2017, Pain.

[6]  Mark I. Johnson,et al.  Transcutaneous electrical nerve stimulation using an LTP-like repetitive stimulation protocol for patients with upper limb complex regional pain syndrome: A feasibility study , 2017 .

[7]  N. Birbaumer,et al.  Pain reduction due to novel sensory-motor training in Complex Regional Pain Syndrome I – A pilot study , 2017, Scandinavian journal of pain.

[8]  J. Macdermid,et al.  Somatosensory rehabilitation for allodynia in complex regional pain syndrome of the upper limb: A retrospective cohort study , 2017, Journal of hand therapy : official journal of the American Society of Hand Therapists.

[9]  A. Turton,et al.  Electrical sensory discrimination therapy in complex Regional Pain Syndrome , 2015 .

[10]  R. Kydd,et al.  The outcome of complex regional pain syndrome type 1: a systematic review. , 2014, The journal of pain : official journal of the American Pain Society.

[11]  J. Marinus,et al.  Health-related quality of life in 975 patients with complex regional pain syndrome type 1 , 2014, PAIN®.

[12]  G. Moseley,et al.  Interventions for treating pain and disability in adults with complex regional pain syndrome. , 2013, The Cochrane database of systematic reviews.

[13]  J. Marinus,et al.  Clinical features and pathophysiology of complex regional pain syndrome , 2011, The Lancet Neurology.

[14]  C. McCabe,et al.  ‘Now you see it, now you do not’: sensory–motor re-education in complex regional pain syndrome , 2011 .

[15]  H. Putter,et al.  BASIC NEUROSCIENCES, GENETICS AND IMMUNOLOGY- ORIGINAL ARTICLE Spreading of complex regional pain syndrome: not a random process , 2022 .

[16]  P. Drummond Sensory disturbances in complex regional pain syndrome: clinical observations, autonomic interactions, and possible mechanisms. , 2010, Pain medicine.

[17]  Frank Birklein,et al.  Validation of proposed diagnostic criteria (the “Budapest Criteria”) for Complex Regional Pain Syndrome , 2010, PAIN.

[18]  D. Amtmann,et al.  Development of a PROMIS item bank to measure pain interference , 2010, PAIN.

[19]  Jennifer S. Lewis Body perception disturbance in complex regional pain syndrome , 2008 .

[20]  Katja Wiech,et al.  Tactile discrimination, but not tactile stimulation alone, reduces chronic limb pain , 2008, PAIN®.

[21]  C. McCabe,et al.  Body perception disturbance: A contribution to pain in complex regional pain syndrome (CRPS) , 2007, PAIN®.

[22]  J. Dieleman,et al.  The incidence of complex regional pain syndrome: A population-based study , 2007, Pain.

[23]  R. Harden,et al.  Complex regional pain syndrome. , 2001, British journal of anaesthesia.

[24]  H. Flor,et al.  Effect of sensory discrimination training on cortical reorganisation and phantom limb pain , 2001, The Lancet.

[25]  A. Reiss,et al.  Syndrome , 1990, Biological Psychiatry.

[26]  P Gossman,et al.  All change for research , 1987, British medical journal.

[27]  Martyn Shuttleworth,et al.  Double Blind Experiment , 2018 .

[28]  A. Kübler,et al.  A brief intervention utilising visual feedback reduces pain and enhances tactile acuity in CLBP patients. , 2015, Journal of back and musculoskeletal rehabilitation.

[29]  V. Braun,et al.  Please Scroll down for Article Qualitative Research in Psychology Using Thematic Analysis in Psychology , 2022 .