The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Activity Modification and Exercise of Treatment of CRPS.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Activity Modification and Exercise of Treatment of CRPS

1. Bed Rest for CRPS

   Bed Rest for CRPS is not recommended for treatment of CRPS

    

2. Aerobic Exercise for CRPS

   Aerobic Exercise for CRPS is recommended for treatment of CRPS

   Indications: every stage of CRPS. If you are largely or entirely non-weight bearing, think about aquatic therapy (see below). The American College of Sports Medicine’s Guidelines for Exercise Testing and Prescription, 9th ed., regarding health screening and risk stratification, should be followed. Those with significant heart problems or significant potential for cardiovascular disease, however, should be validations to instituting vigorous exercises.

    

3. Strengthening Exercises for CRPS

   Frequency/Dose/Duration: Usually, three to five trips per week at first, increasing as necessary for individuals who are more badly afflicted. Most patients with severe CRPS will initially need daily therapies to promote increased activity, advance exercises, and address fear-avoidant thoughts (also known as “necrophobia”). It is reasonable to treat mild to moderate cases two to three times per week.

   To support subsequent visits, there should be observable evidence of strength gains within the first two weeks. The frequency and length of supervised treatment are influenced by the sharpness and severity of the symptoms as well as the existence of concomitant diseases. then move on to exercises at home.

   Even in severe situations, it is advised to start active treatment regimens at the first appointment (also known as “stress loading”), simply complemented with passive modalities as necessary. For the initial few days of treatment, those starting treatment may experience worse symptoms, although pain and edema should pass quickly.

   It is thought to be essential for the patient’s family and the entire treatment team to be aware of this and to keep encouraging the patient to advance rather than to reduce or eliminate active program aspects.

   These are the most significant programming components in the management of a CRPS patient out of all the possible strengthening exercises. Scrubbing, repeated strong grasps, lifting increasingly heavier objects, walking distance, and repeated toe lifts are a few instances of these activities. Strengthening activities should be started at the first appointment and aggressively encouraged at home.

   Patients should be informed that these exercises are the most crucial part of the therapy regimen. To graphically illustrate how the patient’s ability to endure pain is having positive effects and serving as a motivator, it may be especially helpful to track and graph the patient’s improvement throughout the course of therapy sessions. Grip strength, how much or how long you bear weight, and time are all activities that can be graphed.

   Stretching Exercises for CRPS

   Stretching Exercises for CRPS is recommended for treatment of CRPS.

   Indications: Symptoms Severe, ongoing CRPS. maybe recommended, particularly if the patient never uses the extremities in any way. Otherwise, more advantageous choices include image therapy, mirror work, and bolstering. The use of aquatic treatment was substantially or entirely incapable of supporting weight (see below).

   Frequency/Dose/Duration: Begin with three to four weekly appointments; add exercises and show signs of improved functionality.

    

4. Mirror Therapy and Guided Imagery for CRPS

   Mirror Therapy and Guided Imagery for CRPS is recommended for determined individuals with moderate to severe CRPS who are prepared to follow the recommended course of treatment.

   Signs: mild and severe CRPS cases. maybe especially beneficial for those who struggle to follow through with gradual strengthening exercises.

    

5. Aquatic Therapy for CRPS

   for people with CRPS to build greater tolerance to graded activities.

   Indications: Moderate to severe CRPS sufferers. includes those who have underlying medical conditions that make weight bearing difficult (such as severe degenerative joint disease in the lower extremities) or people who have previously engaged in activities like swimming, etc. including those who have severe CRPS in their lower extremities and use wigs.

    

6. Desensitization Techniques for CRPS

   Desensitization Techniques for CRPS is recommended for the treatment of CRPS

   Indications: Patients with moderate to severe CRPS who have pronounced hyperalgesia.

   Should be predominantly involved in a core programme of progressively harder activities, or for whom there is a plan to incorporate such exercises right after or in conjunction with desensitisation methods. (Desensitization techniques are not advised as the only form of exercise or therapy because they are unlikely to be effective for functional restoration.)

   Frequency/Dose/Duration: Initial three weekly appointments, increasing to five if CRPS is severe. Exercises performed at home should also be advised.

    

7. Yoga for CRPS

   Yoga for CRPS is recommended

   Indications: Patients with moderate to severe CRPS. especially advised for yoga enthusiasts who are driven and inquisitive.

   Frequency/Dose/Duration: Initial three weekly appointments, increasing to five if CRPS is severe. Exercises at home should be recommended every day.

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