• Laura Herrador Colmenero, Jose Manuel Perez Marmol, Celia Martí-García, María de Los Ángeles Querol Zaldivar, Rosa María Tapia Haro, Adelaida María Castro Sánchez, and María Encarnación Aguilar-Ferrándiz.
• 1 Universidad de Jaen, Jaen, Spain.
• Prosthet Orthot Int. 2018 Jun 1; 42 (3): 288-298.

BackgroundPhantom limb pain is reported in 50%-85% of people with amputation. Clinical interventions in treating central pain, such as mirror therapy, motor imagery, or virtual visual feedback, could redound in benefits to amputee patients with phantom limb pain.ObjectivesTo provide an overview of the effectiveness of different techniques for treating phantom limb pain in amputee patients.Study DesignSystematic review.MethodsA computerized literature search up to April 2017 was performed using the following databases: PubMed, Scopus, CINAHL, MEDLINE, ProQuest, PEDro, EBSCOhost, and Cochrane Plus. Methodological quality and internal validity score of each study were assessed using PEDro scale. For data synthesis, qualitative methods from the Cochrane Back Review Group were applied.ResultsIn all, 12 studies met our inclusion criteria, where 9 were rated as low methodological quality and 3 rated moderate quality. All studies showed a significant reduction in pain, but there was heterogeneity among subjects and methodologies and any high-quality clinical trial (PEDro score ≤8; internal validity score ≤5) was not found.ConclusionMirror therapy, motor imaginary, and virtual visual feedback reduce phantom limb pain; however, there is limited scientific evidence supporting their effectiveness. Future studies should include designs with more solid research methods, exploring short- and long-term benefits of these therapies. Clinical relevance This systematic review investigates the effectiveness of mirror therapy, motor imagery, and virtual visual feedback on phantom limb pain, summarizing the currently published trials and evaluating the research quality. Although these interventions have positive benefits in phantom limb pain, there is still a lack of evidence for supporting their effectiveness.

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