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Abstract
Phantom limb pain is a common complication after a limb amputation. Its pathophysiology is complex and the pharmacological treatment available is not satisfactory. So, the focus is being diverted towards non-pharmacological therapies such as mirror therapy, a technique described in the 90s by Ramachandran that consists in creating the illusion of seeing the amputated limb by visualizing the reflection of the existing limb in a mirror. A study published in 2007 concluded that it is effective for the treatment of phantom pain in patients with lower limb amputation. The main objective of this work was to review the most recent scientific literature on the application of mirror therapy for the treatment of phantom pain of amputees. As specific objectives, assess the scientific evidence that supports its use, identify contraindications and adverse effects, analyze the application protocols used, and find out if there are indivi-dual factors that could influence the response of patients.
Through a bibliographic search in Medline, Embase, Cochrane Library and Cuiden were located and evaluated two systematic reviews and eight primary studies. Mirror therapy is an affordable therapeutic option, easy to apply, with few contraindications and which does not usually produce severe adverse effects, but not enough scientific evidence has been found to support its use in amputees. There are many doubts regarding its mechanism of action, best form of application and effectiveness. It is necessary to carry out more studies.
References
Alviar MJM, Hale T, Lim-Dungca M. Pharmacologic interventions for treating phantom limb pain. Cochrane Database Syst Rev. 2016;(10).
Barbin J, Seetha V, Casillas JM, Paysant J, Pérennou D. The effects of mirror therapy on pain and motor control of phantom limb in amputees: A systematic review. Ann Phys Rehabil Med. 2016;59(4):270–5.
Chan BL, Witt R, Charrow AP, Magee A, Howard R, Pasquina PF, et al. Mirror Therapy for Phantom Limb Pain. N Engl J Med. 2007;357(21):2206–7.
Datta R, Dhar M. Mirror therapy: An adjunct to conventional pharmacotherapy in phantom limb pain. J Anaesthesiol Clin Pharmacol. 2015;31(4):575.
Finn SB, Perry BN, Clasing JE, Walters LS, Jarzombek SL, Curran S, et al. A Randomized, Controlled Trial of Mirror Therapy for Upper Extremity Phantom Limb Pain in Male Amputees. Front Neurol. 2017;8:267.
Flor H, Diers M, Andoh J. The neural basis of phantom limb pain. Trends Cogn Sci. 2013;17(7):307–8.
Flor H, Nikolajsen L, Staehelin Jensen T. Phantom limb pain: a case of maladaptive CNS plasticity? Nat Rev Neurosci. 2006;7(11):873–81.
Fuchs X, Flor H, Bekrater-Bodmann R. Psychological Factors Associated with Phantom Limb Pain: A Review of Recent Findings. Pain Res Manag. 2018;2018:5080123.
Griffin SC, Curran S, Chan AWY, Finn SB, Baker CI, Pasquina PF, et al. Trajectory of phantom limb pain relief using mirror therapy: Retrospective analysis of two studies. Scand J Pain. 2017;15(1):98–103.
Hagenberg A, Carpenter C. Mirror Visual Feedback for Phantom Pain: International Experience on Modalities and Adverse Effects Discussed by an Expert Panel: A Delphi Study. PM&R. 2014;6(8):708–15.
Herrador Colmenero L, Perez Marmol JM, Martí-García C, Querol Zaldivar M de los Á, Tapia Haro RM, Castro Sánchez AM, et al. Effectiveness of mirror therapy, motor imagery, and virtual feedback on phantom limb pain following amputation: A systematic review. Prosthet Orthot Int. 2018;42(3):288–98.
Imaizumi S, Asai T, Koyama S. Agency over Phantom Limb Enhanced by Short-Term Mirror Therapy. Front Hum Neurosci. 2017;11:483.
Instituto Aragonés de Ciencias de la Salud. Elaboración de guías de práctica clínica en el Sistema Nacional de Salud : manual metodológico. [Internet]. Instituto Aragonés de Ciencias de la Salud; 2007 [cited 2019 May 2]. Available from: https://es.scribd.com/document/174868614/Manual-Metodologico-Elaboracion-GPC-en-El-SNS
Lenggenhager B, Arnold CA, Giummarra MJ. Phantom limbs: pain, embodiment, and scientific advances in integrative therapies. Wiley Interdiscip Rev Cogn Sci. 2014 ;5(2):221–31.
Makin TR, Scholz J, Filippini N, Henderson Slater D, Tracey I, Johansen-Berg H. Phantom pain is associated with preserved structure and function in the former hand area. Nat Commun. 2013;4(1):1570.
Nikolajsen L, Christensen KF, Haroutiunian S. Phantom limb pain: treatment strategies. Pain Manag. 2013;3(6):421–4.
Ol HS, Van Heng Y, Danielsson L, Husum H. Mirror therapy for phantom limb and stump pain: a randomized controlled clinical trial in landmine amputees in Cambodia. Scand J Pain. 2018;18(4):603–10.
Ramadugu S, Nagabushnam SC, Katuwal N, Chatterjee K. Intervention for phantom limb pain: A randomized single crossover study of mirror therapy. Indian J Psychiatry. 2017;59(4):457–64.
Richardson C, Kulkarni J. A review of the management of phantom limb pain: challenges and solutions. J Pain Res. 2017;10:1861–70.
Richardson C. Nursing aspects of phantom limb pain following amputation. Br J Nurs. 2008;17(7):422–6.
Rothgangel A, Braun S, de Witte L, Beurskens A, Smeets R. Development of a Clinical Framework for Mirror Therapy in Patients with Phantom Limb Pain: An Evidence-based Practice Approach. Pain Pract. 2016;16(4):422–34.
Rothgangel A, Braun S, Winkens B, Beurskens A, Smeets R. Traditional and augmented reality mirror therapy for patients with chronic phantom limb pain (PACT study): results of a three-group, multicentre single-blind randomized controlled trial. Clin Rehabil. 2018;32(12):1591–608.
Tavera J. Amputación: Más Allá de un Cambio Físico, un Cambio Mental. Rev El Dolor [Internet]. 2014;(62):20–2. Disponible en: https://www.ached.cl/upfiles/revistas/documentos/55dddb2d3e34c_original3_62_final.pdf
Tilak M, Isaac SA, Fletcher J, Vasanthan LT, Subbaiah RS, Babu A, et al. Mirror Therapy and Transcutaneous Electrical Nerve Stimulation for Management of Phantom Limb Pain in Amputees - A Single Blinded Randomized Controlled Trial. Physiother Res Int. 2016;21(2):109–15.
Villaseñor Moreno JC, Escobar Reyes VH, Sánchez Ortiz ÁO, Quintero Gómez IJ. Dolor de miembro fantasma: fisiopatología y tratamiento. Rev Espec Médico-Quirúrgicas [Internet]. 2014;19(1):62–8. Available from: https://www.redalyc.org/html/473/47330738010/
Yıldırım M, Kanan N. The Effect of Mirror Therapy on the Management of Phantom Limb Pain. Agri. 2016;28(3):127–34.
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