Home-based self-delivered mirror therapy for phantom pain: a pilot study

Abstract

Objective: To test the feasibility and preliminary efficacy of self-delivered home-based mirror therapy for phantom pain.

Design: Uncontrolled prospective treatment outcome pilot study.

Participants: Forty community-dwelling adults with unilateral amputation and phantom pain > 3 on a 0-10 numeric rating scale enrolled either during a one-time study visit (n = 30) or remotely (n = 10).

Methods: Participants received an explanation of mirror therapy and were asked to self-treat for 25 min daily. Participants completed and posted back sets of outcomes questionnaires at months 1 and 2 post-treatment. Main outcome was average phantom pain intensity at post-treatment.

Results: A significant reduction in average phantom pain intensity was found at month 1 (n = 31, p = 0.0002) and at month 2 (n = 26, p = 0.002). The overall median percentage reduction at month 2 was 15.4%. Subjects with high education (> 16 years) compared with low education (< 16 years) (37.5% vs 4.1%) had greater reduction in pain intensity (p = 0.01).

Conclusion: These findings support the feasibility and efficacy of home-based self-delivered mirror therapy; this low-cost treatment may defray medical costs, therapy visits, and the patient travel burden for people with motivation and a high level of education. More research is needed to determine methods of cost-effective support for people with lower levels of education.

Figures

Fig. 1

Subject flowchart. OHSV: Oregon Health & Science University.

Fig. 2

Phantom pain intensity. (A) Raw points and estimated regression line with 95% confidence bands. (B) Box-plot. LSmean: estimated least square means; Sterr: standard error; diff: difference.

Fig. 3

(A) Absolute change in phantom pain from baseline to month 2 for each individual participant, and (B) percentage change. 0 for same as baseline, 0 for increase.