Mirror Therapy in Complex Regional Pain Syndrome Type 1 of the Upper Limb in Stroke Patients

Abstract

. The results indicate that mirror therapy effectively reduces pain and enhances upper limb motor function in stroke patients with upper limb CRPSt1.

Physiotherapy for pain and disability in adults with complex regional pain syndrome (CRPS) types I and II

“…We extracted relevant data from eight included trials (Askin 2014;Aydemir 2006;Cacchio 2009a;Dimitrijevic 2014;Duman 2009;Durmus 2004;Hazneci 2005;Li 2012). We contacted or attempted to contact the corresponding authors of 10 trials on three occasions in order to obtain missing outcomes data (Cacchio 2009b;Jeon 2014;Moseley 2004;Moseley 2005;Moseley 2009;Mucha 1992;Schreuders 2014;Uher 2000). One trial author responded and supplied data for an outcome measure of 'impairment' but we were unable to extract outcome data linked to 'pain intensity' from the supplied data ; one trial author responded stating that they were unable to supply the relevant data (Schreuders 2014); and there was no response from the other trial authors we had contacted.…”

“…Whilst the selected participants in three trials crossed over from comparator to intervention groups (Cacchio 2009b;Moseley 2004;Mucha 1992), none employed a true randomised crossover design and we analysed them up to the point of crossover as parallel group-designs. One trial employed a within-subject randomised crossover design …”

“…There were no trials that included participants with CRPS II. Fourteen trials included participants with CRPS I of the upper limb (Askin 2014;Aydemir 2006;Cacchio 2009a;Cacchio 2009b;Duman 2009;Durmus 2004;Hazneci 2005;Li 2012;Moseley 2004;Moseley 2005;Moseley 2009;Mucha 1992;Schreuders 2014), two with either upper or lower limb CRPS I (Dimitrijevic 2014;, one with CRPS I of the lower limb (Uher 2000) and one trial included participants with either upper, lower, multi-limb or whole body CRPS I (Jeon 2014). Participants developed CRPS I linked to a range of aetiologies including onset post fracture, soft-tissue injuries, stroke, surgery, carpal tunnel syndrome as well as of idiopathic onset.…”

“…Participants developed CRPS I linked to a range of aetiologies including onset post fracture, soft-tissue injuries, stroke, surgery, carpal tunnel syndrome as well as of idiopathic onset. Participants had acute symptoms (less than or equal to three months) of CRPS I in six trials (Cacchio 2009a;Dimitrijevic 2014;Durmus 2004;Hazneci 2005;Li 2012;Mucha 1992), chronic symptoms (greater than three months) in seven trials (Duman 2009;Jeon 2014;Moseley 2004;Moseley 2005;Moseley 2009;Schreuders 2014), a mix of acute and chronic symptoms in two trials (Askin 2014;, and three trials did not report the duration of symptoms (Aydemir 2006;Cacchio 2009b;Uher 2000). Trials were undertaken across a range of geographical locations including: Turkey (N = 5); Australia (N = 4); Italy, Germany, the Netherlands (N = 2 each); China, Serbia, and South Korea (N = 1 each).…”

“…The types of physiotherapy interventions delivered were heterogenous across the included trials and included various electrotherapy modalities (ultrasound, TENS, laser, interferential therapy, pulsed electromagnetic field therapy), cortically-directed sensory-motor rehabilitation strategies (GMI, mirror therapy, virtual body swapping, tactile sensory discrimination training), exercise (active, active-assisted, passive, stretching, strengthening, mobilising, functional; supervised and unsupervised), manual lymphatic drainage (MLD) and pain management advice. Five trials directly compared an active and placebo intervention (Askin 2014;Aydemir 2006;Cacchio 2009a;Cacchio 2009b;Durmus 2004). Six trials evaluated electrotherapy modalities (Askin 2014;Aydemir 2006;Dimitrijevic 2014;Durmus 2004;Hazneci 2005;Mucha 1992), eight trials evaluated cortically-directed sensory-motor rehabilitation strategies (Cacchio 2009a;Cacchio 2009b;Jeon 2014;Moseley 2004;Moseley 2005;Moseley 2009;Schreuders 2014), two trials evaluated MLD (Duman 2009;Uher 2000) and two trials evaluated general rehabilitation therapies (Li 2012;.…”