Preamputation Mirror Therapy May Prevent Development of Phantom Limb Pain: A Case Series

Abstract

We report the cases of 4 patients who performed daily mirror therapy for 2 wk before undergoing elective limb amputation. One patient experienced no phantom limb pain (PLP). Two patients experienced rare episodes of mild PLP without effect on their participation in physical therapy (PT) or their quality of life. One patient reported daily, brief episodes of moderate PLP without effect on his participation in PT or his stated quality of life. These results indicate that preoperative mirror therapy may improve postamputation PT compliance and decrease the incidence of PLP. Future prospective studies are needed to confirm the results of this case series.

The Effect of Mirror Therapy on the Management of Phantom Limb Pain

“…[13,14,[26][27][28][29][30] It is a method that can be used independently by nurses to manage the care of a patient with PLP. In addition, it provides a great opportunity for amputees to be able to manage their pain themselves.…”

“…There are certain findings which proove that mirror therapy decreases PLP by helping the regression of changed cortical map. [28][29][30][31][32][33][34][35][36][37][38][39] Patients with cosmetic prostheses took off the prostheses only when practicing mirror therapy. For a large portion of the day, they were wearing the prosthesis, and thus, may be blocking possible positive effect of mirror therapy on their cortical brain map.…”

“…[24,25] The results of his first study with mirror therapy encouraged many scientists to conduct new studies on this therapy method. [13,14,[26][27][28][29][30] Since mirror therapy is a method that can be taught and practiced easily and independently, it should have a place in the nursing care plan of patients with PLP. However, there is currently no study in the literature related to the role of nurses in using mirror therapy for management of PLP.…”

Mirror Therapy as an Alternative Treatment for Phantom Limb Pain: A Short Literature Review

“…The pathophysiology of PLP is still unknown and is not completely understood, therefore provides a challenge to those involved in the management and treatment of this pain [7]. It has been shown that a range of treatments such as pharmacological treatment, neuromodulation, physical treatment, nerve block and surgical treatment has been unsuccessful in treating PLP and any efficacious methods have yet to be proven [1,8]. …”

“…It was shown that one of the patients experienced no PLP. Rare episodes of mild PLP were experienced by two of the patients, without affecting their quality of life or their participation in physical therapy; one patient reported daily, brief episodes of moderate PLP without any effect on his participation in physical therapy or his stated quality of life [8]. In addition, Kim et al reported the successful reduction of PLP in a 30-year-old male patient with an above-elbow amputation using mirror therapy.…”