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. 2016 Jul;34(3):104-110.

Mirror Therapy for Phantom Limb Pain at a Pediatric Oncology Institution

Doralina L Anghelescu  1 , Cassandra N Kelly  2 , Brenda D Steen  3 , Jianrong Wu  4 , Huiyun Wu  4 , Brian M DeFeo  5 , Kristin Scobey  5 , Laura Burgoyne  6
Affiliations

Mirror Therapy for Phantom Limb Pain at a Pediatric Oncology Institution

Doralina L Anghelescu et al. Rehabil Oncol. 2016 Jul.

Abstract

Background and purpose/objective: Mirror therapy has not been reported for phantom limb pain (PLP) in pediatric oncology. Our aims are to describe the incidence and duration of PLP post-amputation, the duration of follow-up, pain scores and pain medications, and the differences between a group that received mirror therapy (MT) in addition to the standard treatment and a group that received only the standard treatment (non-MT).

Methods: A retrospective review of patients' medical records from June 2009 to March 2015 was completed. The demographic characteristics, diagnoses and types of surgery were collected. The incidence and duration of PLP, duration of pain service follow-up, pain medications and pain scores were collected and analyzed using the Wilcoxon rank sum test.

Results: Of 21 patients who underwent amputations (median age 13 years, range, 8-24 years), most common primary diagnosis osteosarcoma), 18 (85.7%) experienced PLP; 38.9% of them experienced PLP at 1 year post-amputation (11.1% of the MT group and 66.7% of the non-MT group). The MT group and non-MT groups experienced PLP for a mean (± SD) of 246 (± 200) days, and 541 (± 363) days, respectively (p=0.08). The mean (SD) opioid doses (mg/kg/day) in the MT and non-MT groups were 0.81 (± 0.99) and 0.33 (± 0.31), respectively; the mean (SD) gabapentin doses (mg/kg/day) were 40.1 (± 21) for the MT group and 30.5 (± 11.5) for the non-MT group.

Conclusion: MT in children with cancer-related amputations is associated with lower incidence of PLP at 1 year and shorter duration of PLP.

Keywords: mirror therapy; pediatric oncology; phantom limb pain.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Mirror Therapy Study Flowchart (n=21) Footnotes and Abbreviations PLP, phantom limb pain MT, mirror therapy * One patient’s data did not contribute to the duration of PLP and duration of follow up because of still receiving treatment for PLP, including MT, at the closing date for data collection for the study. ** One patient’s data did not contribute to any pain outcomes (i.e., pain scores, pain medications, duration of PLP or duration of follow up) because the clinical scenario was that of an amputation 2 weeks after a limb-sparing operation, followed by another surgical procedure during the course of the study, which confounded the post-amputation pain-outcome measures. *** One patient’s data did not contribute to the duration of PLP and duration of follow up due to being lost to follow-up at 4 weeks due to transfer to another institution.
Figure 2
Figure 2
Duration of Phantom Limb Pain (days), in the Mirror Therapy Group and Non-Mirror Therapy Group (p=0.08) Footnotes and Abbreviations MT, mirror therapy group Non-MT, non-mirror therapy group
See this image and copyright information in PMC

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