Seyyah Mine, Topuz Semra
University of Health Science, Kartal Dr Lütfi Kırdar City Hospital, Burn and Wound Center, Istanbul, Turkey.
Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey.
Burns. 2023 Sep;49(6):1432-1438. doi: 10.1016/j.burns.2022.11.002. Epub 2022 Nov 7.
Mirror therapy is aimed at developing a normal proprioceptive perception for the area with pain or movement restriction by making use of the person's monitoring of the healthy side movements thanks to the mirror's reflective feature. The aim of this study is to investigate the effect of mirror therapy on joint range of motion, pain and functionality in acute upper extremity burn injuries.
Demographic and burn-specific data of individuals with upper extremity burns were recorded. Individuals were divided into two groups. Standard treatment was applied to the first group, and mirror treatment in addition to the standard treatment was applied to the second group for 30 sessions, 5 days a week for 6 weeks. In the standard treatment program, passive, active-assisted and active ROM, strengthening, stretching, resistant and functional exercises were applied. In the mirror therapy group, active exercises were performed on the healthy side by covering the burn area in the mirror box. Before and after the treatment, joint range of motion(ROM) was evaluated with Universal Goniometer, pain intensity was evaluated with Visual Analog Scale and upper extremity functions were evaluated with QuickDASH.
A total of 32 (23 Male, 9 Female) individuals between the ages of 18-65 were included. The mean total burn surface area was 12.93 ± 9.80 in the standard treatment and 6.12 ± 2.96 in the mirror treatment. The groups were similar in terms of ROM change (p > 0.05). The pretest/posttest pain scores of both the standard therapy and mirror therapy groups were similar (p > 0.05). There was no statistically significant difference in terms of pretest and posttest QuickDASH scores according to the groups (p > 0.05). The difference between the pretest/posttest QuickDASH scores of both Standard treatment and Mirror treatment groups was statistically significant.
This study showed that the standard physiotherapy and rehabilitation program applied in the acute period in upper extremity burns and the mirror treatment applied in addition to this program provide similar improvements in joint range of motion and pain.
镜像疗法旨在利用镜子的反射特性，通过让患者观察健康侧的运动，为疼痛或运动受限区域培养正常的本体感觉。本研究的目的是探讨镜像疗法对急性上肢烧伤患者关节活动范围、疼痛及功能的影响。
记录上肢烧伤患者的人口统计学和烧伤相关数据。将患者分为两组。第一组采用标准治疗，第二组在标准治疗的基础上增加镜像治疗，共30次，每周5天，持续6周。在标准治疗方案中，进行被动、主动辅助和主动关节活动度训练、强化训练、伸展训练、抗阻训练和功能训练。在镜像治疗组中，通过在镜像箱中覆盖烧伤区域，对健康侧进行主动训练。治疗前后，使用通用量角器评估关节活动范围（ROM），使用视觉模拟量表评估疼痛强度，使用上肢功能快速评估量表（QuickDASH）评估上肢功能。
共纳入32例年龄在18 - 65岁之间的患者（23例男性，9例女性）。标准治疗组的平均烧伤总面积为12.93 ± 9.80，镜像治疗组为6.12 ± 2.96。两组在ROM变化方面相似（p > 0.05）。标准治疗组和镜像治疗组的治疗前/后疼痛评分相似（p > 0.05）。根据分组，两组的治疗前和治疗后QuickDASH评分无统计学显著差异（p > 0.05）。标准治疗组和镜像治疗组的治疗前/后QuickDASH评分差异具有统计学意义。
本研究表明，上肢烧伤急性期应用的标准物理治疗和康复方案以及在此方案基础上增加的镜像治疗，在关节活动范围和疼痛改善方面效果相似。
