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.2016.07.333

Cited by 6 publications

(5 citation statements)

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“…Interestingly, the patient who had the transplant of both hands showed a reversal of the reorganization in a manner suggesting strengthening of preexisting connections. However, mirror therapy and mental imagery that work directly on the central nervous system have been shown to have beneficial effects with cortical remapping; thus, both central and peripheral inputs are important 77,87,88…”

Section: Discussionmentioning

confidence: 99%

Capsaicin 8% patch treatment for amputation stump and phantom limb pain: a clinical and functional MRI study

Privitera¹,

Birch²,

Sinisi³

et al. 2017

JPR

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PurposeThe aim of this study was to measure the efficacy of a single 60 min application of capsaicin 8% patch in reducing chronic amputation stump and phantom limb pain, associated hypersensitivity with quantitative sensory testing, and changes in brain cortical maps using functional MRI (fMRI) scans.MethodsA capsaicin 8% patch (Qutenza) treatment study was conducted on 14 patients with single limb amputation, who reported pain intensity on the Numerical Pain Rating Scale ≥4/10 for chronic stump or phantom limb pain. Pain assessments, quantitative sensory testing, and fMRI (for the lip pursing task) were performed at baseline and 4 weeks after application of capsaicin 8% patch to the amputation stump. The shift into the hand representation area of the cerebral cortex with the lip pursing task has been correlated with phantom limb pain intensity in previous studies, and was the fMRI clinical model for cortical plasticity used in this study.ResultsThe mean reduction in spontaneous amputation stump pain, phantom limb pain, and evoked stump pain were −1.007 (p=0.028), −1.414 (p=0.018), and −2.029 (p=0.007), respectively. The areas of brush allodynia and pinprick hypersensitivity in the amputation stump showed marked decreases: −165 cm2, −80% (p=0.001) and −132 cm2, −72% (p=0.001), respectively. fMRI analyses provided objective evidence of the restoration of the brain map, that is, reversal of the shift into the hand representation of the cerebral cortex with the lip pursing task (p<0.05).ConclusionThe results show that capsaicin 8% patch treatment leads to significant reduction in chronic pain and, particularly, in the area of stump hypersensitivity, which may enable patients to wear prostheses, thereby improving mobility and rehabilitation. Phantom limb pain (“central” pain) and associated brain plasticity may be modulated by peripheral inputs, as they can be ameliorated by the peripherally restricted effect of the capsaicin 8% patch.

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Section: Discussionmentioning

confidence: 99%

Capsaicin 8% patch treatment for amputation stump and phantom limb pain: a clinical and functional MRI study

Privitera¹,

Birch²,

Sinisi³

et al. 2017

JPR

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“…Sharing the experiences with tools for human-centered design processes will eventually lead to a better understanding of ways to develop user-friendly teletreatments, will enable comparison with products and the efficacy of different methods, and will ultimately lead to higher degrees of user acceptance for eHealth solutions. Mirror therapy has shown promising results in reducing phantom limb pain in 3 controlled studies, however, the evidence is still limited [7,8]. It is still not clear which patients may respond more favorably to mirror therapy than others, but at least some patients who experience no effect through mirror therapy could be more suitable for alternative methods such as virtual or augmented reality [50].…”

Section: Discussionmentioning

confidence: 99%

“…Two recent systematic reviews [7,8] reported that despite the potential merits of mirror therapy, the quality of evidence for patients with phantom limb pain is still low and a detailed description of how to deliver the intervention is lacking. Therefore, we recently developed an evidence-based clinical framework for mirror therapy for patients with phantom limb pain [9] that is currently being tested for effectiveness in a multicenter randomized controlled trial [10].…”

Section: Introductionmentioning

confidence: 99%

Design and Development of a Telerehabilitation Platform for Patients With Phantom Limb Pain: A User-Centered Approach

Rothgangel

Braun

Smeets

et al. 2017

JMIR Rehabil Assist Technol

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BackgroundPhantom limb pain is a frequent and persistent problem following amputation. Achieving sustainable favorable effects on phantom limb pain requires therapeutic interventions such as mirror therapy that target maladaptive neuroplastic changes in the central nervous system. Unfortunately, patients’ adherence to unsupervised exercises is generally poor and there is a need for effective strategies such as telerehabilitation to support long-term self-management of patients with phantom limb pain.ObjectiveThe main aim of this study was to describe the user-centered approach that guided the design and development of a telerehabilitation platform for patients with phantom limb pain. We addressed 3 research questions: (1) Which requirements are defined by patients and therapists for the content and functions of a telerehabilitation platform and how can these requirements be prioritized to develop a first prototype of the platform? (2) How can the user interface of the telerehabilitation platform be designed so as to match the predefined critical user requirements and how can this interface be translated into a medium-fidelity prototype of the platform? (3) How do patients with phantom limb pain and their treating therapists judge the usability of the medium-fidelity prototype of the telerehabilitation platform in routine care and how can the platform be redesigned based on their feedback to achieve a high-fidelity prototype?MethodsThe telerehabilitation platform was developed using an iterative user-centered design process. In the first phase, a questionnaire followed by a semistructured interview was used to identify the user requirements of both the patients and their physical and occupational therapists, which were then prioritized using a decision matrix. The second phase involved designing the interface of the telerehabilitation platform using design sketches, wireframes, and interface mock-ups to develop a low-fidelity prototype. Heuristic evaluation resulted in a medium-fidelity prototype whose usability was tested in routine care in the final phase, leading to the development of a high-fidelity prototype.ResultsA total of 7 categories of patient requirements were identified: monitoring, exercise programs, communication, settings, background information, log-in, and general requirements. One additional category emerged for therapists: patient management. Based on these requirements, patient and therapist interfaces for the telerehabilitation platform were developed and redesigned by the software development team in an iterative process, addressing the usability problems that were reported by the users during 4 weeks of field testing in routine care.ConclusionsOur findings underline the importance of involving the users and other stakeholders early and continuously in an iterative design process, as well as the need for clear criteria to identify critical user requirements. A decision matrix is presented that incorporates the views of various stakeholders in systematically rating and prioritizing user requi...

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“…However, a recent systematic review done in 2016 showed that though studies show effectiveness of MT, majority of them are low evidence studies with a small sample size. Keeping this constraint in mind, only a more definitive conclusion can be reached with an appropriately designed randomized control trial with an adequate sample size [10].…”

Section: Mini Reviewmentioning

confidence: 99%

Phantom Limb Pain: What do we know so far?

Malik¹

2017

BJSTR

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

Cited by 6 publications

References 0 publications

Capsaicin 8% patch treatment for amputation stump and phantom limb pain: a clinical and functional MRI study

Capsaicin 8% patch treatment for amputation stump and phantom limb pain: a clinical and functional MRI study

Design and Development of a Telerehabilitation Platform for Patients With Phantom Limb Pain: A User-Centered Approach

Phantom Limb Pain: What do we know so far?

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