Trajectory of phantom limb pain relief using mirror therapy: Retrospective analysis of two studies

Scandinavian Journal of Pain - Tập 15 - Trang 98-103 - 2017
Sarah C. Griffin1, Sean Curran1, Annie W.Y. Chan2, Sacha B. Finn1, Chris I. Baker3, Paul F. Pasquina1, Jack W. Tsao2,4
1Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States
2University of Tennessee Health Science Center, Memphis, TN 38163, United States
3Laboratory of Brain and Cognition, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, United States
4Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN 38105, United States

Tóm tắt

Abstract Background and purpose Research indicates that mirror therapy reduces phantom limb pain (PLP). Objectives were to determine when mirror therapy works in those who respond to treatment, the relevance of baseline PLP to when pain relief occurs, and what pain symptoms respond to mirror therapy. Methods Data from two independent cohorts with unilateral lower limb amputation were analyzed for this study (n = 33). Mirror therapy consisted of 15-min sessions in which amputees performed synchronous movements of the phantom and intact legs/feet. PLP was measured using a visual analogue scale and the Short-Form McGill Pain Questionnaire. Results The severity of PLP at the beginning of treatment predicted when pain relief occurred. Those with low baseline PLP experienced a reduction (p < 0.05) in PLP by session 7 of treatment, those with medium baseline PLP experienced pain relief by session 14 of treatment, and those with high baseline PLP experienced pain relief by session 21 of treatment. Mirror therapy reduced throbbing, shooting, stabbing, sharp, cramping, aching, tender, splitting, tiring/exhausting, and punishing-cruel pain symptoms. Conclusion The degree of PLP at baseline predicts when mirror therapy relieves pain. Implications This article indicates that the degree of baseline PLP affects when mirror therapy relieves pain: relief occurs by session 7 in patients with low PLP but by session 21 in patients with high PLP. Clinicians should anticipate slower pain relief in patients who begin treatment with high levels of pain.

Tài liệu tham khảo

Packard FR. Life and times of Ambroise Paré, 1510–1590: with a new translation of his apology and account of his journeys in divers places. PB Hoeberm Inc.; 1921. Griffin SC, Tsao JW. A mechanism-based classification of phantom limb pain. Pain 2014;155:2236–42. Ramachandran VS, Hirstein W. The perception of phantom limbs. Brain 1998;121:1603–30. Melzack R. Phantom limbs and the concept of a neuromatrix. Trends Neurosci 1990;13:88–92. Anderson-Barnes VC, McAuliffe C, Swanberg KM, Tsao JW. Phantom limb pain – a phenomenon of proprioceptive memory? Med Hypotheses 2009;73:555–8. Chan BL, Witt R, Charrow AP, Magee A, Howard R, Pasquina PF, Heilman KM, Tsao JW. Mirror therapy for phantom limb pain. N Engl J Med 2007;357:2206–7. Ramachandran VS, Rogers-Ramachandran D. Synaesthesia in phantom limbs induced with mirrors. Proc R Soc Lond B: Biol Sci 1996;263:377–86. Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 1983;17:45–56. Price DD, Von der Gruen A, Miller J, Rafii A, Price C. A psychophysical analysis of morphine analgesia. Pain 1985;22:261–9. Melzack R. The Short-Form McGill Pain Questionnaire. Pain 1987;30:191–7. Farrar JT, Young JP, LaMoreaux L, Werth JL, Poole RM. Clinical importance of changes in pain intensity measured on an 11-point numerical pain rating scale. Pain 2001;94:149–58. Moore A, Moore O, McQuay H, Gavaghan D. Deriving dichotomous outcome measures from continuous data in randomized controlled trials of analgesics: use of pain intensity and visual analogue scales. Pain 1997;69:311–5. Brodie EE, Whyte A, Niven CA. Analgesia through the looking-glass? A randomized controlled trial investigating the effect of viewing a ‘virtual’ limb upon phantom limb pain, sensation, and movement. Eur J Pain 2007;11:428–36. Hunter JP, Katz J, Davis KD. The effect of tactile and visual sensory inputs on phantom limb awareness. Brain 2003;126:579–89. Attal N, Fermanian C, Fermanian J, Lantéri-Minet M, Alchaar H, Bouhassira D. Neuropathic pain: are there distinct subtypes depending on the aetiology or anatomical lesion? Pain 2008;138:343–53. Schley MT, Wilms P, Toepfner S, Schaller HP, Schmelz M, Konrad CJ, Birbaumer N. Painful and nonpainful phantom and stump sensations in acute traumatic amputees. J Trauma Acute Care Surg 2008;65:858–64.
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Scandinavian Journal of Pain

Tập 15

98-103

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