Humberto Marreiros
To describe the longitudinal functional recovery of a patient with refractory lower-limb complex regional pain syndrome (CRPS), a disabling condition associated with pain and motor dysfunction, following individualized KAFO-assisted rehabilitation, and to explore potential mechanisms underlying the observed recovery. Longitudinal case study with retrospective and prospective data collection from 2017 onward, including clinical assessment and validated outcome measures: Numeric Rating Scale, SF-36v2, and Barthel Index. A 62-year-old woman with refractory lower-limb CRPS, multimorbidity, osteoporosis, and multiple fragility fractures developed progressive functional decline and wheelchair dependence despite pharmacological therapy, sympathectomy, and spinal cord stimulation. An individualized rehabilitation program incorporating a carbon-fiber knee-ankle-foot orthosis (KAFO) was introduced. This was associated with marked pain reduction, improved independence, regained assisted ambulation, and sustained functional improvement over time. The observed recovery may reflect not only biomechanical stabilization and safer weight-bearing, but also improved sensory input, body representation, and sensorimotor integration. This case supports a function-oriented approach to advanced CRPS and suggests that orthosis-assisted rehabilitation may contribute to functional and neurophysiological recovery in selected complex patients.