Photograph of mirror box experiment courtesy of Dublin Psychoprosthetics Group.
A team of researchers conducted a study evaluating the efficacy of mirror therapy (MT) to treat phantom limb pain (PLP) and phantom limb movement (PLM). They concluded that, because of the insufficiency of the evidence, they cannot recommend MT as a first intention treatment of PLP. The study was published online May 30 in the Annals of Physical and Rehabilitation Medicine.
The researchers conducted a search on the Medline, Cochrane and Embase databases using the keywords “phantom limb” and “mirror therapy” and read and analyzed 20 studies according to the PRISMA Statement. Of the 20 studies, 12 were on the subject of MT and PLP; three were on MT and PLM; and five were on MT, PLP, and PLM. Among the studies, five were randomized controlled trials (163 patients), six were prospective studies (55 patients), and nine were case studies (40 patients). The methodologies were heterogeneous.
Seventeen of the studies reported the efficacy of MT on PLP, but with low levels of evidence. One randomized controlled trial did not show any significant effect of MT. As to the effect of MT on PLM, eight studies concerned reported effectiveness of MT-four with a low level of evidence and four with a high level of evidence.
The researchers recommend further research to assess the effect of MT on pain, prosthesis use, and body representation, and to standardize protocols.