• H M Oerlemans, R A Oostendorp, T de Boo, L van der Laan, J L Severens, and J A Goris.
• Allied Health Services, University Hospital Nijmegen, The Netherlands.
• Arch Phys Med Rehabil. 2000 Jan 1;81(1):49-56.

ObjectiveTo investigate the effectiveness and cost of physical therapy (PT) or occupational therapy (OT) in patients with reflex sympathetic dystrophy (RSD).DesignProspective randomized controlled trial, with 1 year follow-up.SettingTwo university hospitals.PatientsOne hundred thirty-five patients who had been suffering from RSD of one upper extremity for less than 1 year.InterventionsPatients were assigned to PT, OT, or a control group (social work).Main Outcome MeasuresImprovement in impairment level sumscore (ISS) over 1 year (Student's t test). A difference of 5 ISS points between the groups was defined as being clinically relevant. Furthermore, severity of disability and handicap was measured and tested exploratively (Wilcoxon; alpha = .05), and cost-effectiveness of the groups was calculated.ResultsPT and, to a lesser extent, OT resulted in a significant and also more rapid improvement in the ISS as compared with controls (6 and 4 ISS points, respectively). On a disability level, a positive trend was found in favor of OT. On a handicap level, no differences were found between the groups. PT had an advantage over OT regarding the cost-effectiveness ratio.ConclusionIn different ways PT and OT each contribute to the recovery from RSD of the upper extremity.

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