Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic -
Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
Eur J Phys Rehabil Med. 2024 Apr;60(2):280-291. doi: 10.23736/S1973-9087.23.07625-6. Epub 2024 Jan 10.
There is growing evidence for the effectiveness of mirror therapy (MT) on pain reduction in patients with type I complex regional pain syndrome (CRPS I).
To evaluate the efficacy of MT on pain reduction and hand function in subjects with unilateral upper extremity CRPS I.
Randomized controlled trial with control group cross-over (half cross-over design).
Subjects with CRPS I were outpatients of a university hospital and cooperating centers. All patients carried out the daily exercise at home.
Subjects with unilateral upper extremity CRPS I meeting the Budapest diagnostic criteria.
Subjects were randomly divided into two groups. Group A (N.=13) carried out a ten-minute MT exercise daily, for a total duration of six weeks. Group B (N.=14) acted as a control group for six weeks followed by six weeks of MT with the same characteristics as Group A. Upper extremity active range of motion, strength, dexterity, limb volume, affected-to-unaffected hand temperature difference, and health-related quality of life were evaluated before and after each period. Daily records on the visual analogue scale were used for pain evaluation. Effectiveness was calculated using mixed-effects modelling for between-group comparisons and within-group variability, and identification of significant predictors.
Twenty-three females and four males with an average age of 56.1±9.6 years completed the study. Except for the affected-to-unaffected hand temperature difference, both groups consistently demonstrated significant or near-significant improvements in measured parameters after MT period. The improvements were evident upon an intergroup comparison of Group A and the control period of Group B as well as longitudinally within Group B. No significant improvement was found during the control period.
Principles focused on mirror visual feedback to the central nervous system can sustain promising therapeutic potential as part of the treatment for pain reduction and hand function in CRPS I patients.
MT can be considered as part of the therapeutic regimen employed for the treatment of CRPS I.
越来越多的证据表明镜像疗法（MT）在减轻 I 型复杂性区域疼痛综合征（CRPS I）患者疼痛方面有效。
评估 MT 对单侧上肢 CRPS I 患者疼痛减轻和手部功能的疗效。
随机对照试验，设有对照组交叉（半交叉设计）。
CRPS I 患者为大学医院和合作中心的门诊患者。所有患者均在家中进行日常锻炼。
符合布达佩斯诊断标准的单侧上肢 CRPS I 患者。
患者随机分为两组。A 组（N=13）每天进行十分钟的 MT 运动，总疗程为六周。B 组（N=14）作为对照组，进行六周，随后进行六周与 A 组特征相同的 MT。在每个阶段前后评估上肢主动活动范围、力量、灵巧性、肢体体积、患侧与健侧手温差以及健康相关生活质量。使用视觉模拟量表进行每日疼痛评估。采用混合效应模型进行组间比较和组内变异性分析，以确定显著预测因子。
23 名女性和 4 名男性，平均年龄为 56.1±9.6 岁，完成了研究。除患侧与健侧手温差外，两组在 MT 期后均表现出测量参数的显著或接近显著改善。A 组与 B 组的对照组之间的组间比较以及 B 组的纵向比较均显示出改善。在对照组期间未发现显著改善。
以镜像视觉反馈为中枢神经系统为重点的原则可能具有持续的治疗潜力，可作为 CRPS I 患者减轻疼痛和改善手部功能的治疗方法之一。
MT 可作为治疗 CRPS I 治疗方案的一部分。
