Abstract
Mirror visual feedback was originally devised as a therapeutic tool to relieve perceived involuntarily movements and paralysis in the phantom limb. Since this pioneering work was conducted in the mid-1990s, the technique has been applied to relieve pain and enhance movement in other chronic conditions such as stroke and complex regional pain syndrome (CRPS) type 1. This review describes how mirror visual feedback was first developed with amputees, its original application in CRPS, and how further research has demonstrated its potential benefit within graded motor imagery programs. We discuss the potential mechanisms behind this technique and consider the implications for clinical practice.
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References and Recommended Reading
Gregory R: Mirrors in Mind. London: Penguin; 1997:1–2.
Ramachandran VS, Rogers-Ramachandran D: Synaesthesia in phantom limbs induced with mirrors. Proc Biol Sci 1996, 263:377–386.
Brodie EE, Whyte A, Niven CA: Analgesia through the looking-glass? A randomized controlled trial investigating the effect of viewing a ‘virtual’ limb upon phantom limb pain, sensation and movement. Eur J Pain 2007, 11:428–436.
Hunter JP, Katz J, Davis KD: The effect of tactile and visual sensory inputs on phantom limb awareness. Brain 2003, 126:579–589.
McCabe CS, Haigh RC, Ring EF, et al.: A controlled pilot study of the utility of mirror visual feedback in the treatment of complex regional pain syndrome (type 1). Rheumatology (Oxford) 2003, 42:97–101.
Vladimir Tichelaar YI, Geertzen JH, Keizer D, Pail van Wilgen C: Mirror box therapy added to cognitive behavioural therapy in three chronic complex regional pain syndrome type 1 patients: a pilot study. Int J Rehabil Res 2007, 30:181–188.
Moseley GL: Graded motor imagery is effective for long-standing complex regional pain syndrome: a randomised controlled trial. Pain 2004, 108:192–198.
Moseley GL: Is successful rehabilitation of complex regional pain syndrome simply sustained attention to the affected limb? A randomised clinical trial. Pain 2005, 114:54–61.
Sutbeyaz S, Yavuzer G, Sezer N, Koseoglu BF: Mirror therapy enhances lower-extremity motor recovery and motor functioning after stroke: a randomized controlled trial. Arch Phys Med Rehabil 2007, 88:555–559.
Altschuler EL, Wisdom SB, Stone L, et al.: Rehabilitation of hemiparesis after stroke with a mirror. Lancet 1999, 353:2035–2036.
Ramachandran VS, Hirstein W: The perception of phantom limbs. The D.O. Hebb lecture. Brain 1998, 121:1603–1630.
Acerra NE, Moseley GL: Dysynchiria: watching the mirror image of the unaffected limb elicits pain on the affected side. Neurology 2005, 65:751–753.
Kramer HH, Seddigh S, Moseley GL, Birklein F: Dysynchiria is not a common feature of neuropathic pain. Eur J Pain 2008, 12:128–131.
Chan BL, Witt R, Charrow AP: Mirror therapy for phantom limb pain. N Engl J Med 2007, 357:2206–2207.
Brodie EE, Whyte A, Waller B: Increased motor control of a phantom leg in humans results from the visual feedback of a virtual leg. Neurosci Lett 2003, 34:167–169.
Stanton-Hicks M, Jänig W, Hassenbusch S, et al.: Reflex sympathetic dystrophy: changing concepts and taxonomy. Pain 1995, 63:127–133.
Baron R, Fields HL, Jänig W, et al.: National Institutes of Health Workshop: reflex sympathetic dystrophy/complex regional pain syndromes—state-of-the-science. Anesth Analg 2002, 95:1812–1816.
Lewis JS, Kersten P, McCabe CS, et al.: Body perception disturbance: a contribution to pain in complex regional pain syndrome (CRPS). Pain 2007, 133:1111–1119.
Moseley GL: Distorted body image in complex regional pain syndrome. Neurology 2005, 65:773.
Förderreuther S, Sailer U, Straube A: Impaired self-perception of the hand in complex regional pain syndrome (CRPS). Pain 2004, 110:756–761.
McCabe CS, Haigh RC, Halligan PW, Blake DR: Referred sensations in patients with complex regional pain syndrome type 1. Rheumatology (Oxford) 2003, 42:1067–1073.
Schwoebel J, Friedman R, Duda N, Coslett HB: Pain and the body schema: evidence for peripheral effects on mental representations of movement. Brain 2001, 124:2098–2104.
Galer BS, Butler S, Jensen MP: Case reports and hypothesis: a neglect-like syndrome may be responsible for the motor disturbance in reflex sympathetic dystrophy (complex regional pain syndrome-1). J Pain Symptom Manage 1995, 10:385–391.
Giraux P, Sirigu A: Illusory movements of the paralyzed limb restore motor cortex activity. Neuroimage 2003, 20:S107–S111.
Parsons LM: Temporal and kinematic properties of motor behavior reflected in mentally stimulated action. J Exp Psychol Hum Percept Perform 1994, 20:709–730.
Decety J, Perani D, Jeannerod M, et al.: Mapping motor representations with positron emission topography. Nature 1994, 371:600–602.
Moseley GL: Imagined movements cause pain and swelling in a patient with complex regional pain syndrome. Neurology 2004, 62:1644.
Melzack R: Phantom limbs and the concept of a neuromatrix. Trends Neurosci 1990, 13:88–92.
Moseley GL: Graded motor imagery for pathologic pain: a randomized controlled trial. Neurology 2006, 67:2129–2134.
Fink GR, Marshall JC, Halligan PW, et al.: The neural consequences of conflict between intention and the senses. Brain 1999, 122:497–512.
Dettmers C, Lemon RN, Stephan KM, et al.: Cerebral activation during the exertion of sustained static force in man. Neuroreport 1996, 7:2103–2110.
Sirigu A, Duhamel JR, Cohen L, et al.: The mental representation of hand movements after parietal cortex damage. Science 1996, 273:1564–1568.
McCabe CS, Haigh RC, Halligan PW, Blake DR: Simulating sensory-motor incongruence in healthy volunteers: implications for a cortical model of pain. Rheumatology (Oxford) 2005, 44:509–516.
McCabe CS, Blake DR: Evidence for a mismatch between the brain’s movement control system and the sensory system as an explanation for some pain-related disorders. Curr Pain Headache Rep 2007, 11:104–108.
Harris AJ: Cortical origins of pathological pain. Lancet 1999, 354:1464–1466.
Frith CD, Friston K, Liddle PF, Frackowiak RS: Willed action and the prefrontal cortex in man: a study with PET. Proc Biol Sci 1991, 244:241–246.
Batista AP, Newsome WT: Visuo-motor control: giving the brain a hand. Curr Biol 2000, 10:R145–R148.
Garry MI, Loftus A, Summers JJ: Mirror, mirror on the wall: viewing a mirror reflection of unilateral hand movements facilitates ipsilateral M1 excitability. Exp Brain Res 2005, 163:118–122.
Pleger B, Tegenthoff M, Ragert P, et al.: Sensorimotor returning in complex regional pain syndrome parallels pain reduction. Ann Neurol 2005, 57:425–429. [Published erratum appears in Ann Neurol 2005, 57:609.]
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McCabe, C.S., Haigh, R.C. & Blake, D.R. Mirror visual feedback for the treatment of complex regional pain syndrome (type 1). Current Science Inc 12, 103–107 (2008). https://doi.org/10.1007/s11916-008-0020-7
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DOI: https://doi.org/10.1007/s11916-008-0020-7