Date of Graduation

Fall 11-2010

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Torry Cobb

Abstract

Background: There are an estimated 1.6 million people living with a limb amputation in the U.S. Approximately 50-80% of amputees suffer phantom limb pain (PLP), which is pain felt in the absence of a limb that may manifest as stabbing, burning, throbbing or in some other fashion. Mirror therapy has been proposed as an alternative therapy for the treatment of PLP, but its efficacy as an intervention is yet to be elucidated. The purpose of this article is to review the literature to examine the use of mirror therapy to treat post-amputation PLP. Mirror therapy utilizes a mirror between the intact and non-intact limb to create an illusion of two intact limbs. The intact limb is then exercised while the patient watches the image of the two limbs in movement. Experimentation suggests this reconciliation of motor and visual feedback from the phantom may decrease phantom limb pain.

Method: An extensive literature search was performed using PubMed, CINAHL, Evidence Based Medicine Reviews Multifile and Medline using the keywords “phantom limb” and “mirror therapy,” both individually and in combination. The search was limited to humans, English language, and full text articles available through Pacific University Library and that were published from 2000 to 2010. Two randomized controlled trials and two case reports were retrieved and included in the systematic review for final analysis.

Results: Of the four studies evaluated in this systematic review, all four showed some degree of success in using mirror therapy to reduce phantom limb pain. There were a number of limitations in the studies reviewed, including small sample size, observational study designs, and incomplete reporting of statistics.

Conclusion: The reviewed literature shows that mirror therapy reduces the severity of pain for patients experiencing phantom limb pain, however, using the GRADE approach the current evidence is considered to be of low to moderate quality. Additional large scale randomized controlled trials are needed to validate these findings. For the time being, the initiation of mirror therapy seems to safely provide short term relief for patients post-amputation suffering phantom limb pain.

Keywords: Phantom limb, mirror therapy

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