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128:. As Deconick et al. state in a 2014 review, the mechanism of improved motor control and pain relief may differ from the mechanism of pain relief. Deconick et al., who reviewed only the effects of MVF on sensorimotor control, found that MVF can exert a strong influence on the motor network, mainly through increased cognitive penetration in action control.
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The main treatment strategy for CRPS is physical rehabilitation for return of function and mirror therapy is one of many possible strategies to aid in this goal...There appears to be a clear indication for the use of mirror therapy to be included in the multidisciplinary treatment of CRPS types 1 and
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A 2018 review, (based on 15 studies conducted between 2012 and 2017, out of a pool of 115 publications) also criticized the quality of many reports on mirror therapy (MT), but concluded that "MT seems to be effective in relieving PLP, reducing the intensity and duration of daily pain episodes. It is
49:
The patient then looks into the mirror on the side with the good limb and makes "mirror symmetric" movements, as a symphony conductor might, or as a person does when they clap their hands. The goal is for the patient to imagine regaining control over a missing limb. Because the subject is seeing the
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Fifteen studies were included in the systematic review. Recovery of the upper limb, upper limb function and gross manual dexterity were frequently measured in these studies...In the primary variables in promoting recovery, MT alone showed better results in acute and chronic stroke patients in upper
131:
Although there has been much research on MVF, authors of many review articles complain about the poor methodology often used, for example, small sample sizes or lack of control groups. For this reason, one 2016 review (based on a review of 8 studies) concluded that the level of evidence was
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It is a valid, simple, and inexpensive treatment for PLP. The methodological quality of most publications in this field is very limited, highlighting the need for additional, high-quality studies to develop clinical protocols that could maximise the benefits of MT for patients with
50:
reflected image of the good limb moving, it appears as if the phantom limb is also moving. Through the use of this artificial visual feedback, it becomes possible for the patient to "move" the phantom limb and to unclench it from potentially painful positions.
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Despite considerable research, as of 2016 the underlying neural mechanisms of mirror therapy (MT) for stroke were still unclear. As
Deconick et al. state in a 2014 review, the mechanism of improved motor control may differ from the mechanism of pain relief.
19:
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As to the effect of MT on PLM, the 8 studies concerned reported effectiveness of MT: 4 with a low level of evidence and 4 with a high level of evidence...We cannot recommend MT as a first intention treatment in PLP. The level of evidence is
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According to a 2017 review of fifteen studies that compared mirror therapy to conventional rehabilitation for the recovery of upper-limb function in stroke survivors, mirror therapy was more successful than CR in promoting recovery.
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Use of the mirror may also help recruit the premotor cortex to help with motor rehabilitation...On a number of neurological and psychological levels, mirror therapy may help to reverse elements of learned disuse of the affected
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One of the studies showed all 22 patients went through mirror therapy reported a decrease in pain after 4 weeks of treatment. In contrast, only 17% and 33% of the patients in the two controlled groups reported decrease in
45:
pain (PLP). Ramachandran created a visual (and psychological) illusion of two intact limbs by putting the patient's affected limb into a "mirror box," with a mirror down the center (facing toward a patient's intact limb).
526:
Pérez-Cruzado, D; Merchán-Baeza, JA; González-Sánchez, M; Cuesta-Vargas, AI (2017). "Systematic review of mirror therapy compared with conventional rehabilitation in upper extremity function in stroke survivors".
97:), Ramachandran and Rogers-Ramachandran proposed the "learned paralysis" hypothesis of painful phantom limbs. Their hypothesis was that every time the patient attempted to move the paralyzed limb, they received
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Thirty-seven RCTs (42 analyses, 1685 subjects) were eligible for inclusion in the meta-analysis... Overall, MT could effectively improve motor function and ADL, as well as relieve pain for stroke survivors.
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Treatment with mirror therapy soon expanded beyond its origin in treating phantom limb pain to treatment of other kinds of one-sided pain and loss of motor control, for example in stroke patients with
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A 2018 review based on 1685 patients recovering from hemiplegic stroke found mirror therapy provided significant pain relief, while improving motor functions and activities of daily living (ADL).
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A diagram of a mirror box. A patient inserts a whole hand into one hole and the "phantom" hand into the other. When viewed from an angle, an image of two complete hands is created in the brain.
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Seventeen RCTs involving 633 participants were included. Thirteen studies reported a significant between-group difference favoring mirror therapy in at least one lower extremity outcome.
620:
Louie, DR; Lim, SB; Eng, JJ (2019). "The
Efficacy of Lower Extremity Mirror Therapy for Improving Balance, Gait, and Motor Function Poststroke: A Systematic Review and Meta-Analysis".
857:"'It’s All Done With Mirrors': V.S. Ramachandran and the Material Culture of Phantom Limb Research" by Katja Guenther. Med Hist. 2016 Jul; 60(3): 342–358. doi: 10.1017/mdh.2016.27
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Kamal
Narayan Arya, Underlying neural mechanisms of mirror therapy: Implications for motor rehabilitation in stroke, Neurology India,2016, Volume64, Issue 1, Pages 38-44
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Since the 2000s, the visual illusion of regaining control of a damaged limb, which mirror therapy provides, has also been available through virtual reality or robotics.
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Mirror therapy (MT) and graded motor imagery programmes (GMIP) are two specific modalities of physical therapy which are especially promising options for managing CRPS.
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Thirteen out of seventeen randomized controlled trials found that MT was beneficial for post-stroke patients' legs and feet, according to a 2019 review paper.
151:. In 1999 Ramachandran and Eric Altschuler expanded the mirror technique from amputees to improving the muscle control of stroke patients with weakened limbs.
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Mirror therapy has expanded beyond its origin in treating phantom limb pain to the treatment of other kinds of one-sided pain or disability, for instance,
574:
Yang, Yue; Zhao, Qingchun (October 15, 2018). "Effect of Mirror
Therapy on Recovery of Stroke Survivors: A Systematic Review and Network Meta-analysis".
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Al Sayegb, Samaa; Filén, Tove (2013). "Mirror therapy for
Complex Regional Pain Syndrome (CRPS)—A literature review and an illustrative case report".
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A review article published in 2016 concluded that "Mirror therapy (MT) is a valuable method for enhancing motor recovery in poststroke hemiparesis."
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Ramachandran, V.S., Blakeslee, S.: "Phantoms in the Brain: Probing the
Mysteries of the Human Mind", 1998, William Morrow & Company,
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Jacobs, Benjamin; Creamer, Katharine (July 30, 2015). "Not all smoke and mirrors: mirror therapy for
Complex regional pain syndrome".
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so that, even when the limb was no longer present, the brain had learned that the limb (and subsequent phantom) was paralyzed.
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37:(MVF) is a therapy for pain or disability that affects one side of the patient more than the other side. It was invented by
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A 2018 literature review of phantom limb pain stated that, in randomized controlled trials, mirror therapy reduced pain.
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downloadable segment of radio program looks at historical examples and a present-day case of phantom limbs
313:"The effects of mirror therapy on pain and motor control of phantom limb in amputees: A systematic review"
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264:"Reflections on Mirror Therapy: A Systematic Review of the Effect of Mirror Visual Feedback on the Brain"
109:) that the limb did not move. This feedback stamped itself into the brain circuitry through a process of
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774:"Do Robotics and Virtual Reality Add Real Progress to Mirror Therapy Rehabilitation? A Scoping Review"
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over a missing limb. Mirror therapy is now also widely used for treatment of motor disorders such as
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insufficient to recommend MT as a first intention treatment for phantom limb pain.
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Ramachandran created the mirror box to relieve pain by helping an amputee imagine
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An occupational therapy assistant using mirror therapy to address
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Deconinck, Frederik JA; Smorenburg, Ana RP (August 26, 2014).
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Ramachandran's Mirror box therapy was used in the episode "
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Darbois, Nelly; Guillaud, Albin; Pinsault, Nicolas (2018).
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Campo-Prieto, P; Rodríguez-Fuentes, G (November 14, 2018).
456:"Rehabilitation of hemiparesis after stroke with a mirror"
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2 with a positive effect on both pain and motor function.
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Altschuler, Eric Lewin; Wisdom, Sidney B (12 June 1999).
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in post-stroke patients and limb pain in patients with
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a valid, simple, and inexpensive treatment for PLP."
667:"Cortical mechanisms of mirror therapy after stroke"
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Pages displaying wikidata descriptions as a fallback
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176:Mirror therapy is also a recommended therapy for
73:Ramachandran (right) with his original mirror box
317:Annals of Physical and Rehabilitation Medicine
837:Ramachandran's Reith Lecture on Phantom Limbs
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831:WNYC - Radio Lab: Where Am I? (May 5, 2006)
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403:"Phantom limb pain: A literature review"
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268:Neurorehabilitation and Neural Repair
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852:Mirror therapy aiding US amputees
65:Post-amputation phantom limb pain
16:Treatment for some kinds of pain
178:complex regional pain syndrome
172:Complex regional pain syndrome
59:complex regional pain syndrome
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242:Wilson, Cassandra (2010).
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