Efficacy of Mirror Therapy for Phantom Limb Sensation and Phantom Limb Pain in Amputee: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 WANGFeng-yi ^1,2 , ZHANGJia-qi ² , ZHANGMeng-jie ² , LIUSha-xin ^1,2 , ZHANGRen-gang ^1,2 ,  YANGYong-hong ^1,2

1. Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China;
2. School of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu 610041, China;

Corresponding author：

YANGYong-hong, Email: nicole308@126.com

Keywords：

Mirror therapy; Amputation; Phantom limb sensation; Phantom limb pain; Systematic Review; randomized controlled trial

DOI：

10.7507/1672-2531.20160027

Video：

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Objective To systematically evaluate the efficacy of mirror therapy for phantom limb sensation and phantom limb pain in amputee. Methods Databases include PubMed, EMbase, The Cochrane Library (Issue 9, 2015), CBM, CNKI, VIP and WanFang Data were searched to collect randomized controlled trials (RCTs) about mirror therapy for phantom limb sensation and phantom limb pain in amputee from inception to 1^st Sept. 2015. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then metaanalysis was performed using RevMan 5.3 software. Results A total of 5 RCTs involving 129 patients were included. The results of meta-analysis showed that, there was no significant difference between the mirror therapy group and the control group in relieving the phantom limb sensation and phantom limb pain in amputee (MD=-7.29, 95%CI -27.73 to 13.16, P=0.48). Conclusion Mirror therapy could improve the control of phantom limb, however, there is no sufficient evidence to support the effect of mirror therapy on pain management in amputee. The long-term effect of mirror therapy is still under exploration. Due to the limited quantity and quality of the included studies, larger-sample, high quality designed RCTs are needed to verify the above conclusion.

Citation： WANGFeng-yi, ZHANGJia-qi, ZHANGMeng-jie, LIUSha-xin, ZHANGRen-gang, YANGYong-hong. Efficacy of Mirror Therapy for Phantom Limb Sensation and Phantom Limb Pain in Amputee: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2016, 16(2): 160-165. doi: 10.7507/1672-2531.20160027 Copy

1.	Pirowska A, Wloch T, Nowobilski R, et al. Phantom phenomena and body scheme after limb amputation:a literature review. Neurologia, 2014, 48(1):52-59.
2.	Subedi B, Grossberg GT. Phantom limb pain:mechanisms and treatment approaches. Pain Res Treat, 2011, 2011:864605.
3.	Hsu E, Cohen SP. Postamputation pain:epidemiology, mechanisms, and treatment. J Pain Res, 2013, 6(default):121-136.
4.	Griffin SC, Tsao JW. A mechanism-based classification of phantom limb pain. Pain, 2014, 155(11):2236-2242.
5.	Foell J, Bekrater-Bodmann R, Flor H, et al. Phantom limb pain after lower limb trauma:origins and treatments. Int J Low Extrem Wounds, 2011, 10(4):224-235.
6.	Desmond DM, Maclachlan M. Prevalence and characteristics of phantom limb pain and residual limb pain in the long term after upper limb amputation. Int J Rehabil Res, 2010, 33(3):279-282.
7.	McCormick Z, Chang-Chien G, Marshall B, et al. Phantom limb pain:a systematic neuroanatomical-based review of pharmacologic treatment. Pain Med, 2014, 15(2):292-305.
8.	Alviar MJ, Hale T, Dungca M. Pharmacologic interventions for treating phantom limb pain. Cochrane Database Syst Rev, 2011, 26(12):170-171.
9.	Lee JH, Byun JH, Choe YR, et al. Successful Treatment of Phantom Limb Pain by 1 Hz Repetitive Transcranial Magnetic Stimulation Over Affected Supplementary Motor Complex:A Case Report. Ann Rehabil Med, 2015, 39(4):630-633.
10.	Flor H. Phantom-limb pain:characteristics, causes, and treatment. Lancet Neurol, 2002, 1(3):182-189.
11.	Di Rollo A, Pallanti S. Phantom Limb Pain:Low Frequency Repetitive Transcranial Magnetic Stimulation in Unaffected Hemisphere. Case Rep Med, 2011, 2011:130751.
12.	Tseng CC, Chen PY, Lee YC. Successful treatment of phantom limb pain and phantom limb sensation in the traumatic amputee using scalp acupuncture. Acupunct Med, 2014, 32(4):356-358.
13.	Hasanzadeh Kiabi F, Habibi MR, Soleimani A, et al. Mirror Therapy as an Alternative Treatment for Phantom Limb Pain:A Short Literature Review. Korean J Pain, 2013, 26(3):309-311.
14.	Brodie EE, Whyte A, Waller B. Increased motor control of a phantom leg in humans results from the visual feedback of a virtual leg. Neurosci Lett, 2003, 341(2):167-169.
15.	Brodie EE, Whyte A, Niven CA. Analgesia through the lookingglass? A randomized controlled trial investigating the effect of viewing a ‘virtual’ limb upon phantom limb pain, sensation and movement. Eur J Pain, 2007, 11(4):428-436.
16.	Chan BL, Witt R, Charrow AP, et al. Mirror therapy for phantom limb pain. N Engl J Med, 2007, 357(21):2206-2207.
17.	Tung ML, Murphy IC, Griffin SC, et al. Observation of limb movements reduces phantom limb pain in bilateral amputees. Ann Clin Transl Neurol, 2014, 1(9):633-638.
18.	Tilak M, Isaac SA, Fletcher J, 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, 2015.
19.	Price DD, McGrath PA, Rafii A, et al. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain, 1983, 17(1):45-56.
20.	Melzack R. The McGill Pain Questionnaire:major properties and scoring methods. Pain, 1975, 1(3):277-299.
21.	李静, 李幼平. 不断完善与发展的Cochrane系统评价. 中国循证医学杂志, 2008, 8(9):742-743.
22.	Physiotherapy Evidence Database (PEDro) (1999). PEDro scale. Retrieved November 3, 2010. Available at:http://www.pedro.org.au/english/downloads/pedro-scale/.
23.	钟文昭, 吴一龙, 谷力加. Review Manager (RevMan)——临床医生通向Meta分析的桥梁. 循证医学, 2013, 3(4):234-246.
24.	Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ, 2003, 327(7414):557-560.
25.	Kim SY, Kim YY. Mirror Therapy for Phantom Limb Pain. Korean J Pain, 2012, 25(4):272-274.
26.	Weeks SR, Anderson-Barnes VC, Tsao JW. Phantom limb pain: theories and therapies. Neurologist, 2010, 16(5):277-286.
27.	Reilly KT, Sirigu A. The motor cortex and its role in phantom limb phenomena. Neuroscientist, 2008, 14(2):195-202.
28.	MacIver K, Lloyd DM, Kelly S, et al. Phantom limb pain, cortical reorganization and the therapeutic effect of mental imagery. Brain, 2008, 131(8):2181-2191.
29.	Mercier C, Léonard G. Interactions between Pain and the Motor Cortex:Insights from Research on Phantom Limb Pain and Complex Regional Pain Syndrome. Physiother Can, 2011, 63(3): 305-314.
30.	Moura VL, Faurot KR, Gaylord SA, et al. Mind-body interventions for treatment of phantom limb pain in persons with amputation. Am J Phys Med Rehabil, 2012, 91(8):701-714.
31.	Ramachandran VS, Altschuler EL. The use of visual feedback, in particular mirror visual feedback, in restoring brain function. Brain, 2009, 132(Pt 7):1693-1710.
32.	Rothgangel A, Braun S, de Witte L, et al. Development of a Clinical Framework for Mirror Therapy in Patients with Phantom Limb Pain:An Evidence-based Practice Approach. Pain Pract, 2015.
33.	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. PMR, 2014, 6(8):708-715.
34.	Ramachandran VS, Rogers-Ramachandran D, Cobb S. Touching the phantom limb. Nature, 1995, 377(6549):489-490.

1. Pirowska A, Wloch T, Nowobilski R, et al. Phantom phenomena and body scheme after limb amputation:a literature review. Neurologia, 2014, 48(1):52-59.
2. Subedi B, Grossberg GT. Phantom limb pain:mechanisms and treatment approaches. Pain Res Treat, 2011, 2011:864605.
3. Hsu E, Cohen SP. Postamputation pain:epidemiology, mechanisms, and treatment. J Pain Res, 2013, 6(default):121-136.
4. Griffin SC, Tsao JW. A mechanism-based classification of phantom limb pain. Pain, 2014, 155(11):2236-2242.
5. Foell J, Bekrater-Bodmann R, Flor H, et al. Phantom limb pain after lower limb trauma:origins and treatments. Int J Low Extrem Wounds, 2011, 10(4):224-235.
6. Desmond DM, Maclachlan M. Prevalence and characteristics of phantom limb pain and residual limb pain in the long term after upper limb amputation. Int J Rehabil Res, 2010, 33(3):279-282.
7. McCormick Z, Chang-Chien G, Marshall B, et al. Phantom limb pain:a systematic neuroanatomical-based review of pharmacologic treatment. Pain Med, 2014, 15(2):292-305.
8. Alviar MJ, Hale T, Dungca M. Pharmacologic interventions for treating phantom limb pain. Cochrane Database Syst Rev, 2011, 26(12):170-171.
9. Lee JH, Byun JH, Choe YR, et al. Successful Treatment of Phantom Limb Pain by 1 Hz Repetitive Transcranial Magnetic Stimulation Over Affected Supplementary Motor Complex:A Case Report. Ann Rehabil Med, 2015, 39(4):630-633.
10. Flor H. Phantom-limb pain:characteristics, causes, and treatment. Lancet Neurol, 2002, 1(3):182-189.
11. Di Rollo A, Pallanti S. Phantom Limb Pain:Low Frequency Repetitive Transcranial Magnetic Stimulation in Unaffected Hemisphere. Case Rep Med, 2011, 2011:130751.
12. Tseng CC, Chen PY, Lee YC. Successful treatment of phantom limb pain and phantom limb sensation in the traumatic amputee using scalp acupuncture. Acupunct Med, 2014, 32(4):356-358.
13. Hasanzadeh Kiabi F, Habibi MR, Soleimani A, et al. Mirror Therapy as an Alternative Treatment for Phantom Limb Pain:A Short Literature Review. Korean J Pain, 2013, 26(3):309-311.
14. Brodie EE, Whyte A, Waller B. Increased motor control of a phantom leg in humans results from the visual feedback of a virtual leg. Neurosci Lett, 2003, 341(2):167-169.
15. Brodie EE, Whyte A, Niven CA. Analgesia through the lookingglass? A randomized controlled trial investigating the effect of viewing a ‘virtual’ limb upon phantom limb pain, sensation and movement. Eur J Pain, 2007, 11(4):428-436.
16. Chan BL, Witt R, Charrow AP, et al. Mirror therapy for phantom limb pain. N Engl J Med, 2007, 357(21):2206-2207.
17. Tung ML, Murphy IC, Griffin SC, et al. Observation of limb movements reduces phantom limb pain in bilateral amputees. Ann Clin Transl Neurol, 2014, 1(9):633-638.
18. Tilak M, Isaac SA, Fletcher J, 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, 2015.
19. Price DD, McGrath PA, Rafii A, et al. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain, 1983, 17(1):45-56.
20. Melzack R. The McGill Pain Questionnaire:major properties and scoring methods. Pain, 1975, 1(3):277-299.
21. 李静, 李幼平. 不断完善与发展的Cochrane系统评价. 中国循证医学杂志, 2008, 8(9):742-743.
22. Physiotherapy Evidence Database (PEDro) (1999). PEDro scale. Retrieved November 3, 2010. Available at:http://www.pedro.org.au/english/downloads/pedro-scale/.
23. 钟文昭, 吴一龙, 谷力加. Review Manager (RevMan)——临床医生通向Meta分析的桥梁. 循证医学, 2013, 3(4):234-246.
24. Higgins JP, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. BMJ, 2003, 327(7414):557-560.
25. Kim SY, Kim YY. Mirror Therapy for Phantom Limb Pain. Korean J Pain, 2012, 25(4):272-274.
26. Weeks SR, Anderson-Barnes VC, Tsao JW. Phantom limb pain: theories and therapies. Neurologist, 2010, 16(5):277-286.
27. Reilly KT, Sirigu A. The motor cortex and its role in phantom limb phenomena. Neuroscientist, 2008, 14(2):195-202.
28. MacIver K, Lloyd DM, Kelly S, et al. Phantom limb pain, cortical reorganization and the therapeutic effect of mental imagery. Brain, 2008, 131(8):2181-2191.
29. Mercier C, Léonard G. Interactions between Pain and the Motor Cortex:Insights from Research on Phantom Limb Pain and Complex Regional Pain Syndrome. Physiother Can, 2011, 63(3): 305-314.
30. Moura VL, Faurot KR, Gaylord SA, et al. Mind-body interventions for treatment of phantom limb pain in persons with amputation. Am J Phys Med Rehabil, 2012, 91(8):701-714.
31. Ramachandran VS, Altschuler EL. The use of visual feedback, in particular mirror visual feedback, in restoring brain function. Brain, 2009, 132(Pt 7):1693-1710.
32. Rothgangel A, Braun S, de Witte L, et al. Development of a Clinical Framework for Mirror Therapy in Patients with Phantom Limb Pain:An Evidence-based Practice Approach. Pain Pract, 2015.
33. 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. PMR, 2014, 6(8):708-715.
34. Ramachandran VS, Rogers-Ramachandran D, Cobb S. Touching the phantom limb. Nature, 1995, 377(6549):489-490.

Chinese Journal of Evidence-Based Medicine

Efficacy of Mirror Therapy for Phantom Limb Sensation and Phantom Limb Pain in Amputee: A Systematic Review

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