The American Occupational Therapy Association’s 92nd Annual Conference & Expo was terrific!
We packed up our Mirror Box and travelled to the Indiana Convention Center for the conference last month. The attendance was great, and we really enjoyed visiting with those that stopped by our booth. We hope that you enjoyed the Mirror Box demonstrations!
If you stopped by our booth – THANK YOU!
Check out the article in our library titled “More Than Smoke and Mirrors”, written by Ailin Quinlan.
A little synopsis from the article –
Mirror therapy involves the use of a specially designed box whose exterior features a special mirrored side.
The patient puts the affected limb into the box, while the healthy limb is placed in front of the mirrored exterior surface. The patient then carries out specific movements with the healthy limb in front of the mirror while looking at the reflection in the mirror.
What happens next is an optical illusion which tricks the brain into believing that movements of the healthy limb are actually the movements of the affected limb.
It seems the brain prioritises everything it sees over other messages it receives from other senses.
So, if the brain is tricked into seeing the limb move it will over-ride the negative information it is getting from the other body parts — such as the joints.
The brain then sends out a message to the affected limb that it can move — and gradually, it does.
Read the entire article here.
Cmdr. Jack Tsao is the director of Traumatic Brain Injury programs at the U.S. Bureau of Navy Medicine and Surgery. He was involved in a clinical trial where they designed a randomized, sham-controlled trial of mirror therapy and mental visualization therapy for lower extremity amputees with PLP.
Volunteer subjects were randomized into three groups, each using a different therapy: mirror, covered mirror and mental visualization.
Some of their conclusions after the initial trial were:
- Mirror therapy is more effective than covered mirror or mental visualization therapies
- 6 of 6 mirror and 8 of 9 cross-over subjects improved on mirror therapy – total 14 of 15 (93%) subjects improved
- The first noticeable change was a decrease in the intensity of the pain, followed by a decrease in the length of each episode and then the number of daily episodes.
Mirror Therapy is now used at all three of their military amputee centers: Walter Reed Army Medical Center in Washington, DC, Brooke Army Medical Center in San Antonio, TX, and the Naval Medical Center San Diego, San Diego, CA.
Developmental Medicine & Child Neurology recently published an article that demonstrates the feasibility of mirror therapy in children with hemiplegia.
It indicates a potential effectiveness of mirror therapy in improving strength and motor function of the paretic upper limb.
The abstract is shown below, or you can read the entire article by clicking here
Mirror therapy, which provides the visual illusion of a functional paretic limb by using the mirror reflection of the non-paretic arm, is used in the rehabilitation of hemiparesis after stroke in adults. We tested the effectiveness and feasibility of mirror therapy in children with hemiplegia by performing a pilot crossover study in ten participants (aged 6–14y; five males, five females; Manual Ability Classification System levels: one at leveI I, two at level II, four at level III, three at level IV) randomly assigned to 15 minutes of daily bimanual training with and without a mirror for 3 weeks. Assessments of maximal grasp and pinch strengths, and upper limb function measured by the Shriner’s Hospital Upper Extremity Evaluation were performed at weeks 0 (baseline), 3, 6 (intervention), and 9 (wash-out). Testing of grasp strength behind the mirror improved performance by 15% (p=0.004). Training with the mirror significantly improved grasp strength (with mirror +20.4%, p=0.033; without +5.9%, p>0.1) and upper limb dynamic position (with mirror +4.6%, p=0.044; without +1.2%, p>0.1), while training without a mirror significantly improved pinch strength (with mirror +6.9%, p>0.1; without +21.9%, p=0.026). This preliminary study demonstrates the feasibility of mirror therapy in children with hemiplegia and that it may improve strength and dynamic function of the paretic arm.
Complex regional pain syndrome (CRPS) refers to a chronic condition affecting the nerves and blood vessels of one or more extremities.
Aurora Health Care published an article on CRPS, and listed Mirror Box Therapy as one of the treatment options for CRPS. You can read all about it here.
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Perhaps you have used Mirror Box Therapy, or know of someone who has – please share with us. We want to know the outcome of your therapy. We want to know what experiences you have had. Perhaps you are a clinician, and use this routinely in your practice – we want to hear from you! Our forum is just getting started, but that is a great place to leave us feedback. You can also comment under any of our blog postings.
We are very excited to be attending the AOTA 92nd Annual Conference & Expo! It will be one of the most vibrant gatherings of occupational therapy professionals ever experienced.The conference will be held at the Indiana Convention Center, in Indianapolis, Indiana, on April 26 – 29, 2012 with Pre-Conference Institutes on April 25.
We will be located in Booth #38 – come visit us! Informational resources will be available, along with demonstrations of our Mirror Box!
In March 2008, Arch Phys Med Rehabil, published a study that shows that mirror therapy in addition to a conventional rehabilitation program was more beneficial in terms of motor recovery and hand-related functioning than a similar treatment without mirroring. The objective of the study was to evaluate the effects of mirror therapy on upper-extremity motor recovery, spasticity, and hand-related functioning of inpatients with subacute stroke. Read the entire article here.
As many as 80% of amputees experience some kind of “phantom” sensation in their amputated limbs. However, up to half of those who have them do not receive any treatment for or relief from their pain. This makes phantom pain a chronic pain condition.
What is Phantom Limb Pain?
After a limb is removed, you may continue to feel it, as though it were still there.
Theories About Phantom Pain
No one knows for sure why amputees have phantom pain, but a few possible explanations are widely believed to be true.
- Memory of limb pain– some researchers theorize that after a limb is damaged beyond repair, the brain is “used to” feeling the pain. Even after the limb has been removed, the brain continues to sense the same kind of pain. It is like having a memory of the pain because the pain is wired into the brain.
- Nerve bundle stimulation – the severed nerves around the amputation site either misfire or are stimulated in some way, sending a pain message to the brain. These are the same nerves that used to reach all the way into the limb. Sometimes following surgery, these nerves form bundles called neuromas. When they fire, the brain interprets these signals as if the nerve were still intact, and “feels” pain in the toes.
- Rewiring of the nervous system – there has been evidence that when a limb is amputated, changes take place in the brain and spinal cord that cause pain to be interpreted differently than before. It is not yet clear, however, if this is a cause of phantom pain or if this happens as a result of it.
Symptoms of Phantom Limb Pain
Regardless of its cause, phantom pain can be a debilitating condition. Pain is often described as burning, stabbing and throbbing
Most people describe their phantom pain as if it were coming from the distal parts of the amputated limb. In other words, feet, toes or hands. Phantom sensations are more common in the first few months after surgery than they are several months down the road, but they can happen at any time after an amputation. So how do you treat pain that isn’t there?
Treatment for Phantom Pain
Here are some of the most common approaches.
- Medication – because it is considered a neuropathic disorder, antidepressants and anticonvulsants are often prescribed for phantom pain. NSAIDSs, opioidsand muscle relaxants are also on the list of medications. As with other chronic pain conditions, finding the right medication can take time and patience. Sometimes successful phantom pain relief takes a combination of these medications.
- Mirror therapy– many therapists use mirrors in their treatments to show the brain into a healthy limb in place of a stump. This usually involves placing both limbs in a mirror box, which makes the amputated limb appear intact. The individual is then asked to perform exercises with “both” limbs. This tricks the brain, and effectively reduces phantom pain for some people.
- Stump stimulation – using TENS, applying pain-relief patches or rubbing the stump can relieve phantom pain in some people. Using hot packs and cold packs can work for some people. Providing an alternate sensation from the stump can interrupt pain signals.
- Cognitive therapies – some people find relief from their phantom pain through hypnosis, relaxation or guided imagery. These approaches can change the way the brain interprets phantom sensations, including phantom pain.
Click here to read more about Phantom Pain.
New research is suggesting that Mirror Box Therapy can reduce pain and stiffness for those suffering from arthritis. Mirror Box Therapy can often times convince the patients’ brain that their stiff joints are pain free and easy to move. If you or someone you know suffers from arthritis, take a look at these links.
These articles and other articles on Mirror Box Therapy can also be found in our resource library. Take a look!