Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Key Laboratory of Rehabilitation Medicine of Sichuan Province, Chengdu, Sichuan Province, China.
Clin Rehabil. 2021 Dec;35(12):1710-1721. doi: 10.1177/02692155211027332. Epub 2021 Jul 24.
This systematic review and meta-analysis aimed to evaluate the effects of mirror therapy on phantom limb sensation and phantom limb pain in amputees.
Nine electronic databases (PubMed, EMBASE, MEDLINE, Web of Science, the Cochrane Library, CINAHL, PsycInfo, PreQuest, PEDro) were searched from their inception to May 10th, 2021.
Two authors independently selected relevant studies and extracted the data. The effect sizes were calculated under a random-effects model meta-analysis, and heterogeneity was assessed using the test. The risk of bias was evaluated by the Cochrane risk of bias tool, and the methodological quality was appraised by the PEDro scale. The GRADE approach was applied to assess the confidence of the effect.
A total of 11 RCTs involving 491 participants were included in this review and nine RCTs involving 372 participants were included in meta-analysis. The quality of these studies was from poor to good with scores ranging from 2 to 8 points according to PEDro scale. The pooled SMD showed that mirror therapy reduced the pain with a large effect size (-0.81; 95% CI = -1.36 to -0.25; = 0.005; = 82%; = 372) compared with other methods (four covered mirror, one phantom exercise, three mental visualization, one sensorimotor exercise, one transcutaneous electrical nerve stimulation, one tactile stimuli). The quality of evidence for the outcome pain intensity was determined to be fair according to GRADE approach.
There is fair-quality evidence that MT is beneficial for reducing phantom limb pain.
本系统评价和荟萃分析旨在评估镜像疗法对截肢患者幻肢感和幻肢痛的影响。
从建库到 2021 年 5 月 10 日，我们在 9 个电子数据库（PubMed、EMBASE、MEDLINE、Web of Science、Cochrane Library、CINAHL、PsycInfo、PreQuest、PEDro）中进行了检索。
两位作者独立筛选相关研究并提取数据。采用随机效应模型荟萃分析计算效应大小，并采用 检验评估异质性。采用 Cochrane 偏倚风险工具评估偏倚风险，并采用 PEDro 量表评估方法学质量。采用 GRADE 方法评估效应的置信度。
本综述共纳入 11 项 RCT，涉及 491 名参与者；Meta 分析共纳入 9 项 RCT，涉及 372 名参与者。这些研究的质量从差到好不等，PEDro 量表评分为 2 至 8 分。汇总 SMD 表明，与其他方法相比，镜像疗法可显著减轻疼痛（-0.81；95%CI=-1.36 至-0.25； = 0.005； = 82%； = 372）。根据 GRADE 方法，该结局的疼痛强度的证据质量被确定为中等。
有中等质量证据表明，MT 有助于减轻幻肢痛。
