Rothgangel Andreas Stefan, Braun Susy M, Beurskens Anna J, Seitz Rüdiger J, Wade Derick T
The Department of Health and Technique, Zuyd University of Applied Sciences, Heerlen, The Netherlands.
Int J Rehabil Res. 2011 Mar;34(1):1-13. doi: 10.1097/MRR.0b013e3283441e98.
The objective of this study was to evaluate the clinical aspects of mirror therapy (MT) interventions after stroke, phantom limb pain and complex regional pain syndrome. A systematic literature search of the Cochrane Database of controlled trials, PubMed/MEDLINE, CINAHL, EMBASE, PsycINFO, PEDro, RehabTrials and Rehadat, was made by two investigators independently (A.S.R. and M.J.). No restrictions were made regarding study design and type or localization of stroke, complex regional pain syndrome and amputation. Only studies that had MT given as a long-term treatment were included. Two authors (A.S.R. and S.M.B.) independently assessed studies for eligibility and risk of bias by using the Amsterdam-Maastricht Consensus List. Ten randomized trials, seven patient series and four single-case studies were included. The studies were heterogeneous regarding design, size, conditions studied and outcome measures. Methodological quality varied; only a few studies were of high quality. Important clinical aspects, such as assessment of possible side effects, were only insufficiently addressed. For stroke there is a moderate quality of evidence that MT as an additional intervention improves recovery of arm function, and a low quality of evidence regarding lower limb function and pain after stroke. The quality of evidence in patients with complex regional pain syndrome and phantom limb pain is also low. Firm conclusions could not be drawn. Little is known about which patients are likely to benefit most from MT, and how MT should preferably be applied. Future studies with clear descriptions of intervention protocols should focus on standardized outcome measures and systematically register adverse effects.
本研究的目的是评估中风、幻肢痛和复杂性区域疼痛综合征后镜像疗法（MT）干预的临床情况。两名研究者（A.S.R.和M.J.）独立对Cochrane对照试验数据库、PubMed/MEDLINE、CINAHL、EMBASE、PsycINFO、PEDro、RehabTrials和Rehadat进行了系统的文献检索。对研究设计、中风类型或部位、复杂性区域疼痛综合征和截肢均无限制。仅纳入将MT作为长期治疗的研究。两位作者（A.S.R.和S.M.B.）使用阿姆斯特丹-马斯特里赫特共识列表独立评估研究的纳入资格和偏倚风险。纳入了10项随机试验、7项患者系列研究和4项单病例研究。这些研究在设计、规模、研究条件和结局指标方面存在异质性。方法学质量各不相同；只有少数研究质量较高。重要的临床方面，如对可能副作用的评估，仅得到了不充分的探讨。对于中风，有中等质量的证据表明MT作为一种辅助干预可改善手臂功能的恢复，而关于中风后下肢功能和疼痛的证据质量较低。复杂性区域疼痛综合征和幻肢痛患者的证据质量也较低。无法得出确凿结论。对于哪些患者可能从MT中获益最大以及MT应如何最佳应用知之甚少。未来对干预方案有清晰描述的研究应侧重于标准化结局指标并系统记录不良反应。
