Mirror therapy for an adult with central post-stroke pain: a case report
Tóm tắt
Treatment of central post-stroke pain (CPSP) after a thalamic-capsular stroke is generally based on pharmacological approach as it is low responsive to physiotherapy. In this case report, the use of mirror therapy (MT) for the reduction of CPSP in a subject after a stroke involving thalamus is presented. Five years after a right lenticular-capsular thalamic stroke, despite a good recovery of voluntary movement that guaranteed independence in daily life activities, a 50-year-old woman presented with mild weakness and spasticity, an important sensory loss and a burning pain in the left upper limb. MT for reducing arm pain was administered in 45-min sessions, five days a week, for two consecutive weeks. MT consisted in performing symmetrical movements of both forearms and hands while watching the image of the sound limb reflected by a parasagittal mirror superimposed to the affected limb. Pain severity was assessed using visual analogue scale (VAS) before and after the intervention and at one-year follow-up. After the two weeks of MT, the patient demonstrated 4.5 points reduction in VAS pain score of the hand at rest and 3.9 points during a maximal squeeze left hand contraction. At one-year follow-up, pain reduction was maintained and also extended to the shoulder. This case report shows the successful application of a motor training with a sensory confounding condition (MT) in reducing CPSP in a patient with a chronic thalamic stroke.
Tài liệu tham khảo
Déjerine JJ, Roussy G. Le syndrome thalamique. Rev Neurol (Paris). 1906;14:521–32.
Flaster M, Meresh E, Rao M, Biller J. Central postroke pain: current diagnosis and treatment. Top Stroke Rehabil. 2013;20:116–23.
Yekutiel M. Sensory re-education of the hand after stroke. Whurr: Philadelphia PA; 2000.
Klit H, Finnerup NB, Jensen TS. Central post-stroke pain: clinical characteristics, pathophysiology, and management. Lancet Neurol. 2009;8:857–68.
Hong JH, Choi BY, Chang CH, et al. The prevalence of central poststroke pain according to the integrity of the spinothalamo-cortical pathway. Eur Neurol. 2012;67:12–7.
Lee IH, Kim YN, Son CS, et al. Clinical aspects of screening test tools for central neuropathic pain in patients with thalamic stroke. J Phys Ther Sci. 2011;23:749–52.
Andersen G, Vestergaard K, Ingeman-Nielsen M, Jensen TS. Incidence of central post-stroke pain. Pain. 1995;61:187–93.
Sposato LA, Sharma HA, Khan AR, et al. Thalamic cramplike pain. J Neurol Sci. 2014;336:269–72.
Nasreddine ZS, Saver JL. Pain after thalamic stroke: right diencephalic predominance and clinical features in 180 patients. Neurology. 1997;48:1196–9.
Vestergaard K, Nielsen J, Andersen G, et al. Sensory abnormalities in consecutive, unselected patients with central post-stroke pain. Pain. 1995;61:177–86.
Ramachandran VS, Altschuler EL. The use of visual feedback, in particular mirror visual feedback, in restoring brain function. Brain. 2009;132:1693–710.
Thieme H, Mehrholz J, Pohl M, et al. Mirror therapy for improving motor function after stroke. Cochrane Database Syst Rev. 2012;3:CD008449.
Ramachandran VS, Rogers-Ramachandran D. Synaesthesia in phantom limbs induced with mirrors. Proc Biol Sci. 1996;263:377–86.
Yavuzer G, Selles R, Sezer N, et al. Mirror therapy improves hand function in subacute stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2008;89:393–8.
Sutbeyaz S, Yavuzer G, Sezer N, Koseoglu BF. Mirror therapy enhances lower-extremity motor recovery and motor functioning after stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2007;88:555–9.
Giraux P, Sirigu A. Illusory movements of the paralyzed limb restore motor cortex activity. NeuroImage. 2003;20:S107–11.
Moseley GL, Gallace A, Spence C. Is mirror therapy all it is cracked up to be? Current evidence and future directions. Pain. 2008;138:7–10.
Keith RA, Granger CV, Hamilton BB, Sherwin FS. The functional independence measure: a new tool for rehabilitation. Adv Clin Rehabil. 1987;1:6–18.
Gregson JM, Leathley MJ, Moore AP, et al. Reliability of measurements of muscle tone and muscle power in stroke patients. Age Ageing. 2000;29:223–8.
Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther. 1987;67:206–7.
Beebe JA, Lang CE. Relationships and responsiveness of six upper extremity function tests during the first six months of recovery after stroke. J Neurol Phys Ther. 2009;33:96–103.
Dworkin RH, Turk DC, Wyrwich KW, et al. Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. J Pain. 2008;9:105–21.
Bohannon RW, Schaubert K. Test-retest reliability of grip-strength measures obtained over a 12-week interval from community dwelling elders. J Hand Ther. 2005;18:426–8.
Altschuler EL, Wisdom SB, Stone L, et al. Rehabilitation of hemiparesis after stroke with a mirror. Lancet. 1999;353:2035–6.
Cacchio A, De Blasis E, De Blasis V, Santilli V, Spacca G. Mirror therapy in complex regional pain syndrome type 1 of the upper limb in stroke patients. Neurorehabil Neural Repair. 2009;23(8):792–9.
Pervane Vural S, Nakipoglu Yuzer GF, Sezgin Ozcan D, Demir Ozbudak S, Ozgirgin N. Effects of mirror therapy in stroke patients with complex regional pain syndrome type 1: a randomized controlled study. Arch Phys Med Rehabil. 2016;97(4):575–81.
Woolf C. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011;152:S2–1.
Sprenger T, Seifert CL, Valet M, Andreou AP, Foerschler A, Zimmer C, Collins DL, Goadsby PJ, Tölle TR. Chakravarty MM assessing the risk of central post-stroke pain of thalamic origin by lesion mapping. Brain. 2012;135(Pt 8):2536–45.
Foell J, Bekrater-Bodmann R, Diers M. Flor H mirror therapy for phantom limb pain: brain changes and the role of body representation. Eur J Pain. 2014;18(5):729–39.
Franz EA, Fu Y, Moore M, Winter T, Mayne T, Debnath R, Stringer C. Fooling the brain by mirroring the hand: brain correlates of the perceptual capture of limb ownership. Restor Neurol Neurosci. 2016;34(5):721–32.
Harris AJ. Cortical origin of pathological pain. Lancet. 2000;355:318–9.
Proske U, Gandevia SC. The kinaesthetic senses. J Physiol. 2009;587:4139–46.
Metral M, Chancel M, Brun C, et al. Kinaesthetic mirror illusion and spatial congruence. Exp Brain Res. 2015;233:1463–70.
Tesio L. Secondo Rapporto sull’ictus. Disabilità, riabilitazione, ricerca. Masson 2006.
Cacchio A, De Blasis E, Necozione S, Di Orio F, Santilli V. Mirror therapy for chronic complex regional pain syndrome type 1 and stroke. N Engl J Med. 2009;361(6):634–6.
May S, Serpell M. Diagnosis and assessment of neuropathic pain. F1000 Med Rep. 2009;1:76.
Haanpää M, Attal N, Backonja M, Baron R, Bennett M, Bouhassira D, Cruccu G, Hansson P, Haythornthwaite JA, Iannetti GD, Jensen TS, Kauppila T, Nurmikko TJ, Rice AS, Rowbotham M, Serra J, Sommer C, Smith BH, Treede RD. NeuPSIG guidelines on neuropathic pain assessment. Pain. 2011;152(1):14–27.
Dach Eckeli F, Teixeira RA, Gouvêa AL. Neuropathic pain evaluation tools. Rev Dor São Paulo. 2016;17(Suppl 1):S20–2.