Appareillage : Amputés


Le 01/12/2022 de 17:00 à 18:30


Retour Session

CO182

EFFECT OF MIRROR THERAPY IN THE TREATMENT OF PHANTOM LIMB PAIN IN AMPUTEES: A SYSTEMATIC REVIEW OF RANDOMISED PLACEBO CONTROLED TRIALS

Matthieu Guémann (Brétigny-sur-Orge, France)

Objective : Phantom limb pain (PLP) concerns more than 50% of amputees and has a negative impact on patients’ life. Mirror therapy (MT) is a promising strategy, but its effectiveness remains controversial. We performed a systematic review to: (i) evaluate the effectiveness of MT versus placebo in reducing PLP, (ii) and to determine MT effect on disability and quality of life.

Material / Patients and Methods : We selected RCTs published between 1996 and July 2021 that included patients with unilateral amputation presenting PLP comparing the effects MT with any other technique considered as placebo. The primary outcome was PLP intensity changes and the secondary outcomes were PLP duration, frequency, patients’ disability and quality of life.

Results : Five studies met our selection criteria. Among the four studies with intergroup comparison, only one showed a significant difference, with a positive effect of MT at week 4. Only one study assessed the effect on disability, and found a significant improvement of disability in the MT group at week 10 and month 6.

Discussion - Conclusion : Our systematic review did not allow concluding in favor of MT effectiveness in reducing PLP intensity, frequency and duration and disability. This lack of strong evidence is probably due to (i) low methodological quality, and (ii) lack of statistical power. Future clinical studies should include a higher number of patients, increase the number and frequency of MT sessions, include a long-term follow-up, improve the methodological quality (PEDro scale), and evaluate other criteria (e.g. duration and frequency of painful episodes, disability and quality of life).

Keywords : Amputation, mirror therapy, phantom limb pain, placebo, systematic review