J Barbin1, V Seetha2, J M Casillas3, J Paysant4, D Pérennou5. 1. Département de MPR, Institut de rééducation-Hôpital sud, CHU des Alpes, avenue de Kimberley, 38130 Echirolles, France; Service de MPR, centre hospitalier Tullins, 18, boulevard Michel-Perret, 38210 Tullins, France. Electronic address: b.jessie@hotmail.fr. 2. Département de MPR, Institut de rééducation-Hôpital sud, CHU des Alpes, avenue de Kimberley, 38130 Echirolles, France. 3. Service de rééducation, Centre Hospitalier Universitaire Dijon, 14, rue Gaffarel, 21079 Dijon, France. 4. Institut régional de médecine physique et de réadaptation, 75, boulevard Lobau, 54042 Nancy, France. 5. Département de MPR, Institut de rééducation-Hôpital sud, CHU des Alpes, avenue de Kimberley, 38130 Echirolles, France; Laboratoire LPNC, Université Grenoble Alpes, France.
Abstract
BACKGROUND AND OBJECTIVE: Phantom limb pain (PLP) is a major problem after limb amputation. Mirror therapy (MT) is a non-pharmacological treatment using representations of movement, the efficacy of which in reducing PLP remains to be clarified. Here, we present the first systematic review on MT efficacy in PLP and phantom limb movement (PLM) in amputees (lower or upper limb). METHODS: A search on Medline, Cochrane Database and Embase, crossing the keywords "Phantom Limb" and "Mirror Therapy" found studies which were read and analyzed according the PRISMA statement. RESULTS: Twenty studies were selected, 12 on the subject of MT and PLP, 3 on MT and PLM, 5 on MT and both (PLP and PLM). Among these 20 studies, 5 were randomized controlled trials (163 patients), 6 prospective studies (55 patients), 9 case studies (40 patients) and methodologies were heterogeneous. Seventeen of the 18 studies reported the efficacy of MT on PLP, but with low levels of evidence. One randomized controlled trial did not show any significant effect of MT. As to the effect of MT on PLM, the 8 studies concerned reported effectiveness of MT: 4 with a low level of evidence and 4 with a high level of evidence. An alternative to visual illusion seems to be tactile or auditory stimulation. CONCLUSION: We cannot recommend MT as a first intention treatment in PLP. The level of evidence is insufficient. Further research is needed to assess the effect of MT on pain, prosthesis use, and body representation, and to standardize protocols.
BACKGROUND AND OBJECTIVE: Phantom limb pain (PLP) is a major problem after limb amputation. Mirror therapy (MT) is a non-pharmacological treatment using representations of movement, the efficacy of which in reducing PLP remains to be clarified. Here, we present the first systematic review on MT efficacy in PLP and phantom limb movement (PLM) in amputees (lower or upper limb). METHODS: A search on Medline, Cochrane Database and Embase, crossing the keywords "Phantom Limb" and "Mirror Therapy" found studies which were read and analyzed according the PRISMA statement. RESULTS: Twenty studies were selected, 12 on the subject of MT and PLP, 3 on MT and PLM, 5 on MT and both (PLP and PLM). Among these 20 studies, 5 were randomized controlled trials (163 patients), 6 prospective studies (55 patients), 9 case studies (40 patients) and methodologies were heterogeneous. Seventeen of the 18 studies reported the efficacy of MT on PLP, but with low levels of evidence. One randomized controlled trial did not show any significant effect of MT. As to the effect of MT on PLM, the 8 studies concerned reported effectiveness of MT: 4 with a low level of evidence and 4 with a high level of evidence. An alternative to visual illusion seems to be tactile or auditory stimulation. CONCLUSION: We cannot recommend MT as a first intention treatment in PLP. The level of evidence is insufficient. Further research is needed to assess the effect of MT on pain, prosthesis use, and body representation, and to standardize protocols.
Authors: Kevin Pacheco-Barrios; Paulo Sampaio de Melo; Karen Vasquez-Avila; Alejandra Cardenas-Rojas; Paola Gonzalez-Mego; Anna Marduy; Joao Parente; Ingrid Rebello Sanchez; Pablo Cortez; Meghan Whalen; Luis Castelo-Branco; Felipe Fregni Journal: Princ Pract Clin Res Date: 2021-12-23
Authors: Hunter G Hoffman; David A Boe; Eric Rombokas; Christelle Khadra; Sylvie LeMay; Walter J Meyer; Sam Patterson; Ann Ballesteros; Stephen W Pitt Journal: J Hand Ther Date: 2020-05-30 Impact factor: 1.950