Mirror Therapy Rehabilitation

Mirror therapy rehabilitation has helped many people control their pain independently and in their home environment. It can also help increase movement in a limb, for example, following a stroke. Although initially developed for amputees to control phantom limb pain, it is now commonly used for many different conditions. Some of these conditions include stroke, chronic regional pain syndrome (CRPS) and arthritis.

Pain, Managing It

Reduction in pain is vital to improve quality of life. Pain can cause psychological problems resulting in sleep disorders, anxiety and depression, as well as deterioration in sexual and marital life and family relationships, which lead to social isolation. Using mirror therapy can allow you to manage your pain without having to rely on medications. It is simple, less labor intensive, and less expensive than other types of intervention.

Function & Independence

Mirror therapy can also help improve function. This is important to increase independence. It has been shown that mirror therapy combined with a conventional rehabilitation program enhances lower-extremity motor recovery and motor functioning in stroke patients and improves recovery of arm function. The National Clinical Guideline for Stroke states that the studies undertaking mirror therapy do appear to show some promising results and further research studies are needed.

Our Brain

The brain is known to be “plastic”. Things you do, change the way the limb is represented in the brain. After any injury, the representation of the limb in the brain may be smaller. The degree of this reorganization correlates with the amount of pain experienced.

Mirror therapy involves using a mirror to “trick” the brain into thinking the affected limb is okay. During mirror therapy treatment exercises, the affected limb is covered and hidden behind a mirror. The movement of the good limb is reflected in the mirror, allowing the brain to think the affected limb is moving freely.

The mirror visual feedback therapy uses the brain’s prioritization of visual feedback over the sensation of the limb. The visual feedback from the reflection helps to drive proprioception in the affected limb. Using this illusion helps normalize the movement process. It re-introduces a normal relationship between physical movement and sensory feedback.

It has been shown that reorganization of the brain is partially reversed using mirror therapy and this corresponds with a reduction in pain. This is because using mirror therapy helps “rewire” the brain back to its normal state, hence decrease the pain. The brain will start to “learn” that this limb is okay and therefore will start to move it more easily.

Learn how to use mirror therapy for rehabilitation.

 

References:

Akyuz, G, Kenis, O (2013) Physical Therapy Modalities and Rehabilitation Techniques in the Treatment of Neuropathic Pain Int J Phys Med Rehabil 1:4
Altschuler E, Jeong H.(2008) Mirror therapy in a patient with a fractured wrist and no active wrist extension. Scan J Plast Reconstr Surg Hand Surg. 42:110-111
Flor H, Elbert T, Knecht S, Wienbruch C, Pantev C, Birbaumer N, LarbigW, Taub E (1995) Phantom-limb pain as a perceptual correlate of cortical reorganization following arm amputation. Nature 375:482-484,
Flor H, Diers M, Christmann C, Koeppe C. (2006) Mirror illusions of phantom hand movements brain activity mapped by fMRI. NeuroImage 31: S159.
Intercollegiate Stroke Working Party. (2012) National clinical guideline for stroke, 4th edition. London: Royal College of Physicians
Moseley, GL; Gallace, A; Spence, C (2008), "Is mirror therapy all it is cracked up to be? Current evidence and future directions", PAIN 138 (1): 7–10
Rothgangel AS, Braun SM, Beurskens AJ, Seitz RJ, Wade DT. (2011) The clinical aspects of mirror therapy in rehabilitation: a systematic review of the literature. Int J Rehabil Res. 34(1):1-13
Sutbeyaz S, Yavuzer G, Sezer N, Koseoglu BF. (2007). Mirror therapy enhances lower-extremity motor recovery and motor functioning after stroke: a randomized controlled trial. Arch Phys Med Rehabil 88: 555-9
Yavuzer G, Selles R, Sezer N, Sutbeyaz S, Bussmann JB, Koseoglu F (2008) Mirror therapy improves hand function in subacute stroke: a randomized controlled trial. Arch Phys Med Rehabil; 89: 393–8
Yildirim, M & Kanan, N (2016) The effect of mirror therapy on the management of phantom limb pain Agri 28(3):127-134
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