Effects of routine physical therapy with and without mirror therapy on phantom limb pain and psychosocial adjustment to amputation among prosthetic users

Introduction
The study objective was to determine the effect of conventional physiotherapy treatment with and without mirror therapy on phantom limb pain and psychosocial adjustment to amputation among prosthesis wearers.

Methods
It was a randomized controlled trial. Data were collected in the Physiotherapy Department of the Pakistan Society for the Rehabilitation of the Disabled, Lahore, and University of Lahore teaching hospital, Lahore. Overall, 36 participants with unilateral lower extremity traumatic amputation and phantom limb pain were recruited.

Results
At baseline, the experimental and control groups were comparable for both Numeric Pain Rating Scale (6.17 ± 1.80 and 6.33 ± 1.74) and psychosocial adjustment of the Trinity Amputation and Prosthesis Experience Scales, i.e. general adjustment (19.22 ± 2.39 and 19.67 ± 2.76), adjustment to limitation (12.78 ± 4.36 and 11.72 ± 3.69), and social adjustment (20.22 ± 1.83 and 20.05 ± 2.87). At the end of the 4th week, a significant reduction in pain was observed (2.27 ± 1.17 and 4 ± 1.37). Changes were recorded in general adjustment (22.27 ± 2.63 and 21.89 ± 2.21) and adjustment to limitation (19.67 ± 2.54 and 16.00 ± 3.97) but no significant difference was seen in social adjustment (22.67 ± 1.90 and 21.89 ± 1.99).

Conclusions
Mirror therapy combined with routine physical therapy is a beneficial approach and shows better results in mitigating phantom limb pain and in psychosocial adjustment to the prosthesis than routine physical therapy alone.