scholarly journals 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

2018 ◽  
Vol 32 (12) ◽  
pp. 1591-1608 ◽  
Author(s):  
Andreas Rothgangel ◽  
Susy Braun ◽  
Bjorn Winkens ◽  
Anna Beurskens ◽  
Rob Smeets
Keyword(s):  
Randomized Controlled Trial ◽  
Augmented Reality ◽  
Controlled Trial ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Mirror Therapy ◽  
Limb Pain ◽  
Randomized Controlled ◽  
Study Results ◽  
Patient Reported

Objective: To compare the effects of traditional mirror therapy (MT), a patient-centred teletreatment (PACT) and sensomotor exercises without a mirror on phantom limb pain (PLP). Design: Three-arm multicentre randomized controlled trial. Setting: Rehabilitation centres, hospital and private practices. Subjects: Adult patients with unilateral lower limb amputation and average PLP intensity of at least 3 on the 0–10 Numeric Rating Scale (NRS). Interventions: Subjects randomly received either four weeks of traditional MT followed by a teletreatment using augmented reality MT, traditional MT followed by self-delivered MT or sensomotor exercises of the intact limb without a mirror followed by self-delivered exercises. Main measures: Intensity, frequency and duration of PLP and patient-reported outcomes assessing limitations in daily life at baseline, 4 weeks, 10 weeks and 6 months. Results: In total, 75 patients received traditional MT ( n = 25), teletreatment ( n = 26) or sensomotor exercises ( n = 24). Mean (SD) age was 61.1 (14.2) years and mean (SD) pain intensity was 5.7 (2.1) on the NRS. Effects of MT at four weeks on PLP were not significant. MT significantly reduced the duration of PLP at six months compared to the teletreatment ( P = 0.050) and control group ( P = 0.019). Subgroup analyses suggested significant effects on PLP in women, patients with telescoping and patients with a motor component in PLP. The teletreatment had no additional effects compared to self-delivered MT at 10 weeks and 6 months. Conclusion: Traditional MT over four weeks was not more effective than sensomotor exercises without a mirror in reducing PLP, although significant effects were suggested in some subgroups.

scholarly journals A Randomized, Controlled Trial of Mirror Therapy for Upper Extremity Phantom Limb Pain in Male Amputees

2017 ◽  
Vol 8 ◽  
Author(s):  
Sacha B. Finn ◽  
Briana N. Perry ◽  
Jay E. Clasing ◽  
Lisa S. Walters ◽  
Sandra L. Jarzombek ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Upper Extremity ◽  
Controlled Trial ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Mirror Therapy ◽  
Limb Pain ◽  
Randomized Controlled

scholarly journals Mirror therapy for phantom limb and stump pain: a randomized controlled clinical trial in landmine amputees in Cambodia

2018 ◽  
Vol 18 (4) ◽  
pp. 603-610 ◽  
Author(s):  
Ha Sam Ol ◽  
Yang Van Heng ◽  
Lena Danielsson ◽  
Hans Husum
Keyword(s):  
Low Income ◽  
Controlled Trial ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Controlled Clinical Trial ◽  
Mirror Therapy ◽  
Randomized Controlled ◽  
Stump Pain ◽  
The Difference ◽  
Therapy Interventions

Abstract Background and aims The aim of the study was to examine the effect of mirror and tactile therapy on phantom and stump pain in patients with traumatic amputations, with particular reference to amputees in low-income communities. Methods The study was conducted with an open, randomized, semi-crossover case-control design in rural Cambodia. A study sample of 45 landmine victims with trans-tibial amputations was allocated to three treatment arms; mirror therapy, tactile therapy, and combined mirror-and-tactile therapy. Non-responders from the mono-therapy interventions were crossed over to the alternative intervention. The intervention consisted of 5 min of treatment every morning and evening for 4 weeks. Endpoint estimates of phantom limb pain (PLP), stump pain, and physical function were registered 3 months after the treatment. Results All three interventions were associated with more that 50% reduction in visual analogue scale (VAS)-rated PLP and stump pain. Combined mirror-tactile treatment had a significantly better effect on PLP and stump pain than mirror or tactile therapy alone. The difference between the three treatment arms were however slight, and hardly of clinical relevance. After treatment, the reduction of pain remained unchanged for an observation period of 3 months. Conclusions The study documents that a 4-week treatment period with mirror and/or tactile therapy significantly reduces PLP and stump pain after trans-tibial amputations. Implications The article reports for the first time a randomized controlled trial of mirror therapy in a homogenous sample of persons with traumatic amputations. The findings are of special relevance to amputees in low-resource communities.

scholarly journals Feasibility of a traditional and teletreatment approach to mirror therapy in patients with phantom limb pain: a process evaluation performed alongside a randomized controlled trial

2019 ◽  
Vol 33 (10) ◽  
pp. 1649-1660 ◽  
Author(s):  
Andreas Rothgangel ◽  
Susy Braun ◽  
Rob Smeets ◽  
Anna Beurskens
Keyword(s):  
Randomized Controlled Trial ◽  
Process Evaluation ◽  
Controlled Trial ◽  
Implementation Strategies ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Phantom Pain ◽  
Mirror Therapy ◽  
Technical Problems ◽  
Randomized Controlled

Objective:To evaluate the delivery, acceptance and experiences regarding a traditional and teletreatment approach to mirror therapy as delivered in a randomized controlled trial.Design:Mixed methods, prospective study.Setting:Rehabilitation centres, hospital and private practices.Subjects:Adult patients with phantom pain following lower limb amputation and their treating physical and occupational therapists.Interventions:All patients received 4 weeks of traditional mirror therapy ( n = 51), followed by 6 weeks of teletreatment ( n = 26) or 6 weeks of self-delivered mirror therapy ( n = 25).Main measures:Patient files, therapist logs, log files teletreatment, acceptance questionnaire and interviews with patients and their therapists.Results:In all, 51 patients and 10 therapists participated in the process evaluation. Only 16 patients (31%) received traditional mirror therapy according to the clinical framework during the first 4 weeks. Between weeks 5 and 10, the teletreatment was used by 14 patients (56%) with sufficient dose. Teletreatment usage decreased from a median number of 31 (weeks 5–10) to 19 sessions (weeks 11–24). Satisfactory teletreatment user acceptance rates were found with patients demonstrating higher scores (e.g. regarding the usefulness to control pain) than therapists. Potential barriers for implementation of the teletreatment perceived by patients and therapists were related to insufficient training and support as well as the frequency of technical problems.Conclusion:Traditional mirror therapy and the teletreatment were not delivered as intended in the majority of patients. Implementation of the teletreatment in daily routines was challenging, and more research is needed to evaluate user characteristics that influence adherence and how technology features can be optimized to develop tailored implementation strategies.

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