Fondazione Santa Lucia, Scientific Institute for Research, Hospitalization and Health Care, Rome.
Physical Medicine and Rehabilitation Unit - IRCCS Istituto Ortopedico Rizzoli, University of Bologna.
Int J Rehabil Res. 2023 Jun 1;46(2):193-198. doi: 10.1097/MRR.0000000000000582. Epub 2023 Apr 21.
Mirror therapy is a widely used treatment for phantom limb pain (PLP) relief in patients with limb loss. Less common is progressive muscle relaxation (PMR), used mostly in other medical conditions (psychological, terminal cancer pain, etc). The purpose of this study is to evaluate the efficacy of a mirror therapy preceded by PMR intervention compared to mirror therapy preceded by unguided generic relaxation-mirror therapy in patients with lower limb amputation suffering from PLP. This pilot study was a single-blind, controlled, randomized trial. Thirty lower limb amputees suffering from PLP were recruited and randomly assigned to three groups respectively undergoing a PMR-mirror therapy rehabilitative intervention, generic relaxation-mirror therapy, and conventional physiotherapy (ConvPT). Selected items from Prosthesis Evaluation Questionnaire (PEQ) and the Brief Pain Inventory (BPI) were used to test the pain features at the beginning and 1 week after 3 weeks of intervention. A decrease of about 65% was found in the rate and duration of PLP at the PEQ in PMR-mirror therapy with respect to generic relaxation-mirror therapy (about 30%) and ConvPT (about 6%). A decrease of about 90% in intensity (worst and average) of PLP in PMR-mirror therapy when compared to generic relaxation-mirror therapy (about 45%) and ConvPT (about 20%) was found at the BPI. We preliminary concluded, albeit with limitations due to the small sample of patients, that mirror therapy can improve PLP when associated with PMR. Further studies are required to confirm that PMR could be an effective technique for more successful PLP management.
镜像疗法是一种广泛应用于缓解肢体缺失患者幻肢痛（PLP）的治疗方法。较少使用的是渐进性肌肉松弛（PMR），主要用于其他医疗情况（心理、晚期癌症疼痛等）。本研究旨在评估 PMR 干预前的镜像疗法与 PMR 干预前的无指导通用放松-镜像疗法在下肢截肢并患有 PLP 的患者中的疗效。这是一项单盲、对照、随机试验。招募了 30 名患有 PLP 的下肢截肢患者，并将他们随机分配到分别接受 PMR-镜像疗法康复干预、通用放松-镜像疗法和常规物理疗法（ConvPT）的三组。使用来自假肢评估问卷（PEQ）和简明疼痛量表（BPI）的选定项目来测试干预 3 周后 1 周和开始时的疼痛特征。与通用放松-镜像疗法（约 30%）和 ConvPT（约 6%）相比，PMR-镜像疗法在 PEQ 中 PLP 的发生率和持续时间下降了约 65%。与通用放松-镜像疗法（约 45%）和 ConvPT（约 20%）相比，在 BPI 中 PMR-镜像疗法中 PLP 的强度（最严重和平均）下降了约 90%。我们初步得出结论，尽管由于患者样本量小存在局限性，但当镜像疗法与 PMR 联合使用时，可以改善 PLP。需要进一步的研究来证实 PMR 可能是更成功地管理 PLP 的有效技术。
