Comparison of Efficacy of Mirror Therapy vs. Mental Imagery in Reduction of Phantom Limb Pain in Above-Knee Amputee Patients: A Comparative Study Mirror Therapy vs. Mental Imagery for PLP
Main Article Content
Abstract
Background: Phantom limb pain (PLP) is a common and debilitating condition affecting amputees, characterized by pain in the absent limb. Despite available pharmacological treatments, non-pharmacological interventions like mirror therapy (MT) and mental imagery (MI) have shown promise in managing PLP.
Objective: To compare the efficacy of mirror therapy versus mental imagery in reducing PLP among above-knee amputee patients.
Methods: A randomized clinical trial was conducted at Hamid Latif Hospital and Ghurki Hospital, Lahore, involving 24 above-knee amputees aged 12-75 years with PLP for at least three months. Participants were randomly assigned to Group A (MT) or Group B (MI). MT sessions involved 30 minutes of mirror reflection exercises, while MI sessions included 30 minutes of guided mental visualization of limb movements. Pain was assessed using the Numeric Pain Rating Scale (NPRS) before and after the intervention. Data were analyzed using SPSS 25 with Mann-Whitney U and Wilcoxon signed-rank tests.
Results: Group A showed a significant reduction in NPRS scores with a mean rank of 9.79 (p=0.052), while Group B had a mean rank of 15.21 (p=0.052), indicating a trend towards greater efficacy in the MT group.
Conclusion: Both mirror therapy and mental imagery effectively reduced PLP, with mirror therapy showing a slightly superior effect.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Bekrater-Bodmann R, Reinhard I, Diers M, Fuchs X, Flor H. Relationship of Prosthesis Ownership and Phantom Limb Pain: Results of a Survey in 2383 Limb Amputees. Pain. 2021;162(2):630-40.
Xie HM, Zhang KX, Wang S, Wang N, Wang N, Li X, et al. Effectiveness of Mirror Therapy for Phantom Limb Pain: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil. 2022;103(5):988-97.
Schober TL, Abrahamsen C. Patient Perspectives on Major Lower Limb Amputation: A Qualitative Systematic Review. Int J Orthop Trauma Nurs. 2022;46:100958.
Peters BR, Russo SA, West JM, Moore AM, Schulz SA. Targeted Muscle Reinnervation for the Management of Pain in the Setting of Major Limb Amputation. SAGE Open Med. 2020;8:2050312120959180.
Limakatso K, Corten L, Parker R. The Effects of Graded Motor Imagery and Its Components on Phantom Limb Pain and Disability in Upper and Lower Limb Amputees: A Systematic Review Protocol. Syst Rev. 2016;5:1-6.
Rierola-Fochs S, Merchán-Baeza JA, Minobes-Molina E. Effectiveness of Graded Motor Imagery Protocol in Phantom Limb Pain in Amputee Patients: Protocol of a Randomized Clinical Trial. PLoS One. 2022;17(8).
Zernitz M, Rizzello C, Rigoni M, Van de Winckel A. Case Report: Phantom Limb Pain Relief After Cognitive Multisensory Rehabilitation. Front Pain Res. 2024;5:1374141.
Limakatso K, Bedwell GJ, Madden VJ, Parker R. The Prevalence and Risk Factors for Phantom Limb Pain in People with Amputations: A Systematic Review and Meta-Analysis. PLoS One. 2020;15(10).
Jalalmanesh M, Elahi N, Kardaani MA, Goharpaie S, Maraghi E. The Effect of Movement Correction Exercises with and Without Mirror Therapy on Pain and Disability with Chronic Low Back Patients: A Randomized Control Trial. Jundishapur J Chronic Dis Care. 2024;13(3).
Brenner I, Jalsevac A, Woodend K. Physical Activity for the Treatment of Phantom Limb Pain.
Lotze M, Moseley GL. Clinical and Neurophysiological Effects of Progressive Movement Imagery Training for Pathological Pain. J Pain. 2022;23(9):1480-91.
Sugawara AT, De Pretto LR, Simis M, Fregni F, Battistella LR. Primary Motor Area Activity in Phantom Limb Imagery of Traumatic Unilateral Lower Limb Amputees with Phantom Limb Pain. Adv Rehabil Sci Pract. 2024;13:27536351241261023.
Mollà-Casanova S, Page Á, López-Pascual J, Inglés M, Sempere-Rubio N, Aguilar-Rodríguez M, et al. Effects of Mirror Neuron Activation Therapies on Functionality in Older Adults: Systematic Review and Meta-Analysis. Geriatr Nurs. 2024;56:115-23.
Akhlaghdoust M, Shakeri M, Faraji M, Khanmirzaei A. Central Nervous System Neuromodulation Techniques for Management of Phantom Limb Pain: A Review of Clinical Trials. Interv Pain Med Neuromodulation. 2023(In Press).
Barbin J, Seetha V, Casillas JM, Paysant J, Perennou D. The Effects of Mirror Therapy on Pain and Motor Control of Phantom Limb in Amputees: A Systematic Review. Ann Phys Rehabil Med. 2016;59(4):270-5.
Herrador Colmenero L, Perez Marmol JM, Martí-García C, Querol Zaldivar MdlÁ, Tapia Haro RM, Castro Sánchez AM, et al. Effectiveness of Mirror Therapy, Motor Imagery, and Virtual Feedback on Phantom Limb Pain Following Amputation: A Systematic Review. Prosthet Orthot Int. 2018;42(3):288-98.
Tureanu LM, Stojiljkovic L. Phantom Limb Pain. Chronic Pain Management in General and Hospital Practice. 2021:261-77.
McClintick A, Nilsson N. Motor Imagery: The Power of Imagination. Azusa Pacific University; 2021.
Alim MA, Akter A, Razzaque A, Mim AA, Alam E, Karim MR, et al. Neurodevelopmental Treatment (NDT) Approach for Improving Balance in the Hemiplegic Stroke Patient: A Comprehensive Case Study.