Improvement of catastrophizing and allodynia by passive range of motion exercise with attention to movement time: A case report

[Purpose] This case report describes a treatment course for catastrophizing and allodynia-like symptoms occurring after cardiosurgery. [Subject] A female in her seventies, who showed inflammatory reaction around the operative wound of median sternotomy and exaggerated pain with shoulder movement four months after surgery, was treated. The subject also expressed pessimistic statements about her body and was negative about social participation. [Methods] Passive ROM shoulder horizontal abduction was repeated at various movement speeds. The subject was told about the movement speed before each trial, and was instructed to pay attention to the actual movement speed during each trial. [Results] After two months treatment, the subject could tolerate faster speeds of passive shoulder movement, and the catastrophizing and allodynia-like symptoms were alleviated. [Conclusion] Passive ROM and distracting a subject’s attention from the pain itself allowed the patient to control the pain, which may have promoted relief from the fear-avoidance model of exaggerated pain.