The effects of mirror therapy on pain and motor control of phantom limb in amputees: A systematic review

Barbin, Jessie; Seetha, V.; Casillas, Jean-Marie; Paysant, Jean; Pérennou, Dominic

doi:10.1016/j.rehab.2016.04.001

Cited by 137 publications

(107 citation statements)

References 45 publications

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“…This treatment decreased pain and oedema and reduced the speed of limb laterality recognition in CRPS (although one study failed to replicate the effect of pain reduction [56]). Mirror visual feedback and graded motor imagery can also reduce pain and improve motor function in other chronic pain conditions, particularly phantom limb pain [207,210,211]. Prism adaptation [212,213], adapted from rehabilitation of poststroke neglect, is hypothesised to normalise attention bias and/or the sensory-motor integration system in CRPS.…”

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confidence: 99%

Neuropsychological Changes in Complex Regional Pain Syndrome (CRPS)

Halicka

Vitterso

Proulx

et al. 2020

Behavioural Neurology

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Complex Regional Pain Syndrome (CRPS) is a poorly understood chronic pain condition of multifactorial origin. CRPS involves sensory, motor, and autonomic symptoms primarily affecting one extremity. Patients can also present with neuropsychological changes such as reduced attention to the CRPS-affected extremity, reminiscent of hemispatial neglect, yet in the absence of any brain lesions. However, this “neglect-like” framework is not sufficient to characterise the range of higher cognitive functions that can be altered in CRPS. This comprehensive literature review synthesises evidence of neuropsychological changes in CRPS in the context of potential central mechanisms of the disorder. The affected neuropsychological functions constitute three distinct but not independent groups: distorted body representation, deficits in lateralised spatial cognition, and impairment of non-spatially-lateralised higher cognitive functions. We suggest that many of these symptoms appear to be consistent with a broader disruption to parietal function beyond merely what could be considered “neglect-like.” Moreover, the extent of neuropsychological symptoms might be related to the clinical signs of CRPS, and rehabilitation methods that target the neuropsychological changes can improve clinical outcomes in CRPS and other chronic pain conditions. Based on the limitations and gaps in the reviewed literature, we provide several suggestions to improve further research on neuropsychological changes in chronic pain.

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confidence: 99%

Neuropsychological Changes in Complex Regional Pain Syndrome (CRPS)

Halicka

Vitterso

Proulx

et al. 2020

Behavioural Neurology

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“…With increase in awareness about the therapy coupled with the boom of online availability of consumer goods, mirror boxes are now also up for sale on the internet and are therefore, more easily available than ever before 9 . However, further research is needed to assess the effect of mirror therapy on pain, use of prosthesis, body representation, as well as to standardize protocols 5 . Mirror therapy is an initial step toward the development of therapeutic targets for technical interventions including brain computer interfaces (BCIs) that are aimed at ameliorating the negative effects which are associated with limbs that are impaired or missing 2 .…”

Section: Resultsmentioning

confidence: 99%

“…Mirror therapy cannot be recommended as a first intention treatment in phantom limb pain 3,5 . Nevertheless, mirror therapy is a method evolved to alleviate the patients from phantom limb pain 1,2 .…”

Section: Methodsmentioning

confidence: 99%

“…Patients then observe and control their injured arm or leg in the mirror, but they are actually observing and controlling the reflected uninjured arm or leg. The brain and spinal cord are visually tricked into believing that all of the arms and legs are intact and without pain 5 . It was found that these soldiers had major problems with phantom pain after amputation.…”

Section: Methodsmentioning

confidence: 99%

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Mirror Therapy

Sekhon¹,

Minhas²

2016

Int J Pharma Res Health Sci

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“…15 Other treatments have also been studied in systematic reviews, although they are often based on even more limited evidence. They include perioperative interventions, 16 transcutaneous electrical nerve stimulation (TENS), 17,18 acupuncture, 19 mirror therapy 20 and myoelectric and body-powered prostheses. 21 This combination of limited evidence and a lack of guidelines for the management of PLP represents a major challenge for clinicians.…”

Section: Surveymentioning

confidence: 99%

Brain and spinal stimulation therapies for phantom limb pain: a systematic review

Corbett

South

Harden

et al. 2018

Health Technol Assess

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Background Although many treatments exist for phantom limb pain (PLP), the evidence supporting them is limited and there are no guidelines for PLP management. Brain and spinal cord neurostimulation therapies are targeted at patients with chronic PLP but have yet to be systematically reviewed. Objective To determine which types of brain and spinal stimulation therapy appear to be the best for treating chronic PLP. Design Systematic reviews of effectiveness and epidemiology studies, and a survey of NHS practice. Population All patients with PLP. Interventions Invasive interventions – deep brain stimulation (DBS), motor cortex stimulation (MCS), spinal cord stimulation (SCS) and dorsal root ganglion (DRG) stimulation. Non-invasive interventions – repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). Main outcome measures Phantom limb pain and quality of life. Data sources Twelve databases (including MEDLINE and EMBASE) and clinical trial registries were searched in May 2017, with no date limits applied. Review methods Two reviewers screened titles and abstracts and full texts. Data extraction and quality assessments were undertaken by one reviewer and checked by another. A questionnaire was distributed to clinicians via established e-mail lists of two relevant clinical societies. All results were presented narratively with accompanying tables. Results Seven randomised controlled trials (RCTs), 30 non-comparative group studies, 18 case reports and 21 epidemiology studies were included. Results from a good-quality RCT suggested short-term benefits of rTMS in reducing PLP, but not in reducing anxiety or depression. Small randomised trials of tDCS suggested the possibility of modest, short-term reductions in PLP. No RCTs of invasive therapies were identified. Results from small, non-comparative group studies suggested that, although many patients benefited from short-term pain reduction, far fewer maintained their benefits. Most studies had important methodological or reporting limitations and few studies reported quality-of-life data. The evidence on prognostic factors for the development of chronic PLP from the longitudinal studies also had important limitations. The results from these studies suggested that pre-amputation pain and early PLP intensity are good predictors of chronic PLP. Results from the cross-sectional studies suggested that the proportion of patients with severe chronic PLP is between around 30% and 40% of the chronic PLP population, and that around one-quarter of chronic PLP patients find their PLP to be either moderately or severely limiting or bothersome. There were 37 responses to the questionnaire distributed to clinicians. SCS and DRG stimulation are frequently used in the NHS but the prevalence of use of DBS and MCS was low. Most responders considered SCS and DRG stimulation to be at least sometimes effective. Neurosurgeons had mixed views on DBS, but most considered MCS to rarely be effective. Most clinicians thought that a randomised trial design could be successfully used to study neurostimulation therapies. Limitation There was a lack of robust research studies. Conclusions Currently available studies of the efficacy, effectiveness and safety of neurostimulation treatments do not provide robust, reliable results. Therefore, it is uncertain which treatments are best for chronic PLP. Future work Randomised crossover trials, randomised N-of-1 trials and prospective registry trials are viable study designs for future research. Study registration The study is registered as PROSPERO CRD42017065387. Funding The National Institute for Health Research Health Technology Assessment programme.

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The effects of mirror therapy on pain and motor control of phantom limb in amputees: A systematic review

Abstract: 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.

Cited by 137 publications

References 45 publications

Neuropsychological Changes in Complex Regional Pain Syndrome (CRPS)

Neuropsychological Changes in Complex Regional Pain Syndrome (CRPS)

Mirror Therapy

Brain and spinal stimulation therapies for phantom limb pain: a systematic review

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