Abstract
Background: Mirror visual feedback (mirror therapy) is practiced worldwide in very
different ways to alleviate phantom pain; no study has compared these variations yet or
researched the associated risk and harm.
Objectives: To establish use and justification of a generally accepted mirror visual
feedback treatment plan after amputation; to explore the occurrence and handling of
adverse effects; and to increase knowledge about contributing factors.
Methods: Experiential knowledge of 13 experienced practitioners from 6 countries and
5 professions was explored with a 3-round Delphi technique.
Results: Experience with the use of 5 different treatment plans was described, of which
1 has never been mentioned in the literature: an intense 1-off plan in which the illusion was
carefully set up before the patient was left to the experience with no interference, resolving
pain as well as adverse effects. In the 4 known treatment plans, the expectations of response
time varied, which influenced the definition of responders/nonresponders; the set-ups,
control, and use of material reflected the professional background of the practitioners.
Contraindications also were defined according to the professional confidence to deal with
the adverse effects. Adverse effects were reported, including emotional reactions, pain
increase, sensory changes, freezing of the phantom limb, dizziness, and sweating. The
attitude toward, and the handling of, adverse effects varied in patients as in practitioners
according to their professional background. A tool to fine tune the experience was reported
with covering of the limb during therapy. Full consensus was reached on several treatment
modalities.
Conclusion: Analysis of the results suggests that the different treatment plans suit
different patients and practitioners. Matching these could enhance effectiveness and
compliance. Knowledge about adverse effects needs to inform treatment decisions. These
findings triggered the development of a mirror visual feedback gateway to guide patients to
the treatment plan for their needs, and to collect data from the practitioners to enhance
neuroscientific understanding and inform practice.
| Original language | English |
|---|---|
| Pages (from-to) | 708-715 |
| Journal | PM and R |
| Volume | 6 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - Aug 2014 |
Bibliographical note
NOTICE: this is the author’s version of a work that was accepted for publication in PM and R.Changes resulting from the publishing process, such as peer review, editing, corrections,
structural formatting, and other quality control mechanisms may not be reflected in this
document. Changes may have been made to this work since it was submitted for
publication. A definitive version was subsequently published in PM and R, 6 (8), DOI 10.1016/j.pmrj.2014.01.005
Keywords
- Phantom pain
- mirror therapy