• Roberto S G M Perez, H Margreet Oerlemans, Wouter W A Zuurmond, and Jaap J De Lange.
• Department of Anesthesiology, VU university medical center Amsterdam, The Netherlands.
• Disabil Rehabil. 2003 Sep 2; 25 (17): 984-91.

ObjectivesTo construct a single indicator on impairment level for lower extremity Complex Regional Pain syndrome type I (CRPS I).DesignThe Impairment level SumScore (ISS) for upper extremity CRPS I was adapted to be used for lower extremity evaluation. Medline literature search and research findings were used to adapt the upper extremity version of the ISS, with emphasis on reliability, responsiveness and validity of measurement instruments. Where needed, additional patient data was gathered to evaluate these aspects for different measurement instruments.SettingAn outpatient clinic of a university hospital in the Netherlands.ParticipantsTwo groups consisting of 17 and 26 healthy volunteers, and two groups of respectively 40 and 18 lower extremity CRPS I patients according to Veldman's criteria.Main Outcome MeasuresVAS and McGill pain scores, water displacement volumeter values, and physicians' and patients' assessment of CRPS I severity.ResultsA combination of measurements, incorporating pain (VAS and McGill), temperature (infrared thermometer), volume (water displacement volumeter) and active range of motion (universal goniometer), was converted in a single score ranging from 5 to 50. The reliability, as well as the responsiveness was adequate.ConclusionsThe lower extremity ISS permits evaluation of the most prominent symptoms in CRPS I, and can be used to monitor changes in CRPS I.

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