Article

Phantom limb pain (PLP) is a major problem after limb
amputation. Mirror therapy (MT) is a non-pharmacological treatment using
representations of movement, the efficacy of which in reducing PLP remains to be
clarified. Here, we present the first systematic review on MT efficacy in PLP and
phantom limb movement (PLM) in amputees (lower or upper limb). METHODS: A search
on Medline, Cochrane Database and Embase, crossing the keywords "Phantom Limb"
and "Mirror Therapy" found studies which were read and analyzed according the
PRISMA statement. RESULTS: Twenty studies were selected, 12 on the subject of MT
and PLP, 3 on MT and PLM, 5 on MT and both (PLP and PLM). Among these 20 studies,
5 were randomized controlled trials (163 patients), 6 prospective studies (55
patients), 9 case studies (40 patients) and methodologies were heterogeneous.
Seventeen of the 18 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, the 8 studies concerned reported
effectiveness of MT: 4 with a low level of evidence and 4 with a high level of
evidence. An alternative to visual illusion seems to be tactile or auditory
stimulation. CONCLUSION: We cannot recommend MT as a first intention treatment in
PLP. The level of evidence is insufficient. Further research is needed to assess
the effect of MT on pain, prosthesis use, and body representation, and to
standardize protocols.
CI - Copyright (c) 2016 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS