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Effectiveness of Mirror Therapy for Phantom Limb Pain: A Systematic Review and Meta-analysis

  • Author Footnotes
    ⁎ Xie, Zhang, and Wang contributed equally to this work.
    Hui-Min Xie
    Footnotes
    ⁎ Xie, Zhang, and Wang contributed equally to this work.
    Affiliations
    Department of Rehabilitation Medicine, First Medical Centre, Chinese PLA General Hospital, Beijng
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  • Author Footnotes
    ⁎ Xie, Zhang, and Wang contributed equally to this work.
    Ke-Xue Zhang
    Footnotes
    ⁎ Xie, Zhang, and Wang contributed equally to this work.
    Affiliations
    Department of Pediatric Surgery, Chinese PLA General Hospital, Beijng
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  • Author Footnotes
    ⁎ Xie, Zhang, and Wang contributed equally to this work.
    Shuo Wang
    Footnotes
    ⁎ Xie, Zhang, and Wang contributed equally to this work.
    Affiliations
    Department of Orthopedic Surgery, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, China
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  • Ning Wang
    Affiliations
    Department of Rehabilitation Medicine, First Medical Centre, Chinese PLA General Hospital, Beijng
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  • Na Wang
    Affiliations
    Department of Rehabilitation Medicine, First Medical Centre, Chinese PLA General Hospital, Beijng
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  • Xia Li
    Affiliations
    Department of Rehabilitation Medicine, First Medical Centre, Chinese PLA General Hospital, Beijng
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  • Li-Ping Huang
    Correspondence
    Corresponding author Li-Ping Huang, PhD, Department of Rehabilitation Medicine, First Medical Centre, Chinese PLA General Hospital, No. 28 Fuxing Rd, Beijing, Haidian District 100853, People's Republic of China.
    Affiliations
    Department of Rehabilitation Medicine, First Medical Centre, Chinese PLA General Hospital, Beijng
    Search for articles by this author
  • Author Footnotes
    ⁎ Xie, Zhang, and Wang contributed equally to this work.
Published:August 27, 2021DOI:https://doi.org/10.1016/j.apmr.2021.07.810

      Abstract

      Objective

      To evaluate the effectiveness of mirror therapy (MT) for phantom limb pain (PLP).

      Data Sources

      PubMed, EMBASE, Ovid MEDLINE, Scopus, Cochrane Library, Physiotherapy Evidence Database, CNKI, and WanFang Data were used to search for studies published up to March 31, 2021.

      Study Selection

      Randomized controlled trials (RCTs) comparing the pain intensity of MT for PLP were performed. A total of 2094 articles were found. Among them, 10 were eligible for the final analysis.

      Data Extraction

      The quality of the RCTs was assessed using the Physiotherapy Evidence Database (PEDro) scale by 2 independent reviewers. Outcome data were pooled according to follow-up intervals (1, 3, 6, and 12mo). Duration times were used as a basis for distinguishing subgroups. The primary evaluation was by visual analog scale. The PEDro scale was used to assess the methodological quality of studies.

      Data Synthesis

      Meta-analysis revealed a statistically significant decrease in pain in the MT group vs the control group within 1 month (I2=0%; standardized mean difference [SMD]=−0.46, 95% confidence interval [CI], −0.79 to −0.13; P = .007). The patients with pain for longer than 1 year benefited more from MT (I2=0%; SMD=−0.46; 95% CI, −0.85 to −0.07; P = .02).

      Conclusions

      MT has beneficial effects for patients with PLP in the short-term, as evidenced by their improved pain scores. There was no evidence that MT had a long-term effect, but that may be a product of limited data. For patients with long-term PLP, MT may be an effective treatment.

      Keywords

      List of abbreviations:

      CI (confidence interval), MT (mirror therapy), PEDro (Physiotherapy Evidence Database), PLP (phantom limb pain), RCT (randomized controlled trial), SMD (standardized mean difference), TENS (transcutaneous electric nerve stimulation), VAS (visual analog scale)
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