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

Yildirim, Meltem; Kanan, Nevin

doi:10.5505/agri.2016.48343

Cited by 25 publications

(15 citation statements)

References 34 publications

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“…In addition, two newer studies were not captured by the systematic reviews utilized by our review to assess the efficacy of mirror therapy and associated techniques. 130 , 131 Brunelli et al reported significant reduction in PLP intensity (n=51). However, it is impossible to identify which participants had PLP and which phantom limb sensation, as both were inclusion criteria; hence, potential bias remains high.…”

Section: Discussion – the Challenges For Future Researchmentioning

confidence: 94%

A review of the management of phantom limb pain: challenges and solutions

Richardson¹,

Kulkarni²

2017

JPR

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BackgroundPhantom limb pain (PLP) occurs in 50% and 80% of amputees. Although it is often classified as a neuropathic pain, few of the large-scale trials of treatments for neuropathic pain included sufficient numbers of PLP sufferers to have confidence that they are effective in this condition. Many therapies have been administered to amputees with PLP over the years; however, as of yet, there appears to be no first-line treatment.ObjectivesTo comprehensively review the literature on treatment modalities for PLP and to identify the challenges currently faced by clinicians dealing with this pain.MethodMEDLINE, EMBASE, CINAHL, British Nursing Index, Cochrane and psycINFO databases were searched using “Phantom limb” initially as a MeSH term to identify treatments that had been tried. Then, a secondary search combining phantom limb with each treatment was performed to find papers specific to each therapy. Each paper was assessed for its research strength using the GRADE system.ResultsThirty-eight therapies were identified. Overall, the quality of evidence was low. There was one high-quality study which used repetitive transcutaneous magnetic stimulation and found a statistical reduction in pain at day 15 but no difference at day 30. Significant results from single studies of moderate level quality were available for gabapentin, ketamine and morphine; however, there was a risk of bias in these papers. Mirror therapy and associated techniques were assessed through two systematic reviews, which conclude that there is insufficient evidence to support their use.ConclusionNo decisions can be made for the first-line management of PLP, as the level of evidence is too low. Robust studies on homogeneous populations, an understanding of what amputees consider a meaningful reduction in PLP and agreement of whether pain intensity is the legitimate therapeutic target are urgently required.

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Section: Discussion – the Challenges For Future Researchmentioning

confidence: 94%

A review of the management of phantom limb pain: challenges and solutions

Richardson¹,

Kulkarni²

2017

JPR

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“…Some studies combined patients with amputation of LL and UL (Darnall and Li, 2012;Sumitani et al, 2008;Yıldırım and Kanan, 2016). The first study (Darnall and Li, 2012) The greatest difference was reported by a client who had felt his phantom limb as completely stiff for 13 years, but felt strong movement illusions during MT.…”

Section: Discussionmentioning

confidence: 99%

Mirror therapy in post amputation patients with phantom limb pain: a mapping study

Chrastina¹,

Svízelová²

2019

Kontakt

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Objective: One of the complications in patients after limb amputation is phantom pain (PP) in the missing limb. Mirror therapy (MT) is a non-pharmacological approach to PP. The objective of the study is to describe and assess possible applications, effectiveness, practicability, and international experience with MT in patients with PP after limb amputation. Methods: A descriptive mapping study that analyses, compares, and clusters the content of 22 relevant studies. The search was performed between 2000 and 2017 using the keywords and their combinations in the following databases: EBSCO, PsychINFO, PubMed, ProQuest, ScienceDirect, including metasearch engines. Results: The specificities of PP after the application of MT in post amputation patients vary by the location of the amputated limb. MT alleviates PP in patients after amputation of the upper limb, lower limb, as well as in mixed groups (after amputation of the upper limb or lower limb); virtual MT is considered an alternative approach. MT remains a rather experimental therapeutic modality aimed at patients, where other attempts to alleviate PP have failed. Regarding the fact that MT is frequently modified and combined with other approaches (including various indications), the effectiveness of MT cannot be fully generalized. The main finding is the evidence of a short-term effect of MT on decreasing the intensity of PP. Conclusions: Although MT is a relatively new phenomenon compared with other therapies, approaches and interventions, it is well known in foreign countries, and the range of indication is increasing. For MT to be generally spread and acknowledged, further research is needed together with a transfer of knowledge to teams providing comprehensive care to these patients. The outcomes of the mapping study will be used for a detailed analysis of the issue in the Czech Republic, where MT is used rarely and as an experimental additional therapy (particularly in occupational therapy).

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“…(14,15,24,28) Multiprofessional programs offering chronic pain nursing practices, with patient-centered care, low complexity psychological approaches (cognitive behavioral therapy), combined with lifestyle reorientation, are interventions that have stood out in the studies, with potential emphasis on rehabilitation, promotion of self-care, ability to promote comfort, minimization of suffering and promotion of quality of life, as well as meditation. (12,13,15,17,19,24,25) These programs constitute a multidisciplinary approach (9,16,17) and for those with pain and life-threatening risks, the implementation of a palliative care program is essential for receiving appropriate interventions from trained professionals for problematic symptoms, thus improving quality of life, as they aim to reduce pain and other symptoms. (20) The continuing offering of Continuing Education is highlighted as an important ally in pain management.…”

Section: Discussionmentioning

confidence: 99%

Práticas de enfermagem ao paciente com dor crônica: revisão integrativa

et al. 2018

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Resumo Objetivo Conhecer os benefícios das práticas de enfermagem aos pacientes com dor acompanhados na clinica de dor. Métodos Revisão integrativa de literatura, sendo utilizado o portal eletrônico SCIELO, e base de dados CINAHL e PubMed Central, com recorte temporal de 2008 a 2018 e período de coleta de dados entre junho e julho de 2018. Como descritores em saúde (DeCs): Pacientes, Dor crônica, Cuidados de Enfermagem, Clínicas de dor; e, o Medical Subject Heading (MeSH): Patients, Chronic pain, Nurse Care, Pain clinic. Resultados Evidenciou-se que a produção analisada é, majoritariamente, sobre práticas de enfermagem não farmacológica a pacientes com dor crônica, com publicações reduzidas no Brasil e tendem a se concentrar nos últimos cinco anos. O paciente com este tipo de agravo, vivencia condições multifatoriais que influenciam diretamente na condição de saúde, e necessitando de acompanhamento integral por equipe interprofissional, com inclusão da rede cuidadora, através intervenções qualificadas e resolutivas, visando adaptação e ou melhora da sua condição de saúde. Conclusão Os estudos indicam benefícios gerados pelas práticas sistematizadas implementadas por enfermeiros, por meio de instrumentos e ferramentas para detecção, intervenção e avaliação, além de apoio clínico.

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

Cited by 25 publications

References 34 publications

A review of the management of phantom limb pain: challenges and solutions

A review of the management of phantom limb pain: challenges and solutions

Mirror therapy in post amputation patients with phantom limb pain: a mapping study

Práticas de enfermagem ao paciente com dor crônica: revisão integrativa

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