In 1999, Severens, et. al., conducted study about Reflex Sympathetic Dystrophy (RSD) which poses a challenging scenario for patients, particularly in the realm of treatment effectiveness and associated costs. In an effort to shed light on this matter, a two-center randomized clinical trial was conducted to compare the cost-effectiveness of adjuvant treatments, specifically pairwise physical therapy (PT), occupational therapy (OT), and control treatment (CT).

The study included 135 patients with RSD of one upper extremity, all within the first year of diagnosis. The primary outcome measures were the Impairment-level Sum Score (ISS), the modified Greentest, and the Sickness Impact Profile (SIP). Patients were randomly assigned to receive PT, OT, or CT, with PT and OT following predefined protocols, while CT involved services provided by social workers.

The Impairment-level Sum Score (ISS) demonstrated a significant difference between PT versus OT and CT, indicating a clinical improvement in patients undergoing physical therapy. However, no significant differences were observed in the modified Greentest and SIP. From a cost perspective, the mean adjuvant treatment costs were significantly higher for PT (NLG 1,726) and OT (NLG 2,089) compared to CT (NLG 903). Surprisingly, the mean total medical costs did not exhibit significant differences among the groups (PT, NLG 8,692; OT, NLG 13,023; CT, NLG 7,888) according to the intention-to-treat analysis.

Physical therapy emerged as a clinically relevant and cost-effective intervention for RSD patients. Despite the higher adjuvant treatment costs associated with PT and OT, the incremental cost-effectiveness ratios demonstrated that PT was not only more effective but also less costly compared to its counterparts. These findings emphasize the potential benefits of physical therapy in managing RSD, presenting a promising avenue for improving patient outcomes while keeping healthcare costs in check. Sensitivity analyses indicated a moderate influence of cost estimates, supporting the robustness of the study’s conclusions. Overall, this research provides valuable insights into the cost-effectiveness of adjuvant therapies for RSD, guiding clinicians and policymakers in making informed decisions for optimal patient care.

Reference: Severens, J. L., Oerlemans, H. M., Weegels, A. J., van’t Hof, M. A., Oostendorp, R. A., & Goris, R. J. A. (1999). Cost-effectiveness analysis of adjuvant physical or occupational therapy for patients with reflex sympathetic dystrophy. Archives of Physical Medicine and Rehabilitation, 80(9), 1038-1043.