Bibliographic identification CHASÁKOVÁ, Ludmila. Utility of the "mirror therapy" in the treatment complex regional pain syndrome (type I). Prague: Charles University, 2nd Faculty of Medicine, Department of Rehabilitation and Sports Medicine, 2014. 105 s. Supervisor Mgr. Stanislav Machač. Annotation Objectives: Introduction of "mirror therapy" (MT) principles in patients with Type 1 complex regional pain syndrome (CRPS). Verification of the effectiveness of the MT in terms of sensory, functional and morphological changes. Participants: Sixteen patients (14 women and 2 men, age 55.3±10.5 years) and 10 controls (7 women and 3 men, age 54.9±7.6 years) were included in this study. All of them were diagnosed as patients with Type I CRPS. Methods and measure: The intervention group underwent 6 weeks of MT. Both groups recorded numerical scale pain for 6 weeks. At the beginning and end of the period, all probands underwent examination including: range of motion of wrist flexion and extension, thenar temperature side-to-side difference, volume of the hand and forearm, dynamometry, PegBoard, ability to close the fist, Wind-Up, referred sensations and EQ-5D-3L questionnaire. Results: A statistically significant reduction in pain at rest and during movement was found in the intervention group, not in the control group....

A terapia do espelho, técnica utilizada no tratamento de pacientes em reabilitação neurológica, tem mostrado bons resultados a um custo relativamente baixo. Nessa terapia, um espelho é colocado ao longo do plano sagital mediano do paciente entre os dois membros, superiores ou inferiores, com o intuito de transmitir estímulos visuais para o cérebro para induzir a ilusão dos membros em questão estarem se deslocando de forma síncrona. Considerando a simplicidade, os resultados obtidos e o baixo custo da terapia do espelho, neste trabalho exploramos recursos tipicamente disponíveis em dispositivos móveis do tipo tablet e smartphones para propor um modelo de acompanhamento remoto baseado na gravação e no compartilhamento de vídeos de sessões de terapia do espelho considerando dois tipos de usuários: terapeutas e pacientes. O modelo é apresentado na forma de um protótipo de um sistema de acompanhamento remoto de pacientes que utilizam a terapia do espelho em sua reabilitação. Especialistas avaliaram que o sistema apresenta grande potencial no auxilio à reabilitação de membros superiores, podendo ser utilizado por qualquer paciente em reabilitação pela terapia do espelho devido à sua facilidade de uso. Entre os trabalhos futuros viabilizados pela versão atual do sistema estão testes com pacientes em tratamento para verificação das implicações resultantes de sua utilização. / The mirror therapy technique used in the treatment of patients in neurological rehabilitation has shown good results in a relatively low cost. In this therapy, a mirror is placed along the median sagittal plane of the patient between the two limbs, higher or lower, in order to transmit visual stimuli to the brain to induce the illusion of the limbs are moving synchronously. Considering the simplicity, the results obtained and the low cost of mirror therapy in this work we explore resources available on mobile devices like tablet and smartphones to propose a remote monitoring model based on recording and sharing videos of mirror therapy sessions considering two types of users: therapists and patients. The model is presented as a prototype of a remote monitoring system of patients that use mirror therapy in their rehabilitation. Experts evaluated that the system presents great potential to aid in the rehabilitation of the upper limbs and may be used by any patient due to its ease of use. Among the future work made possible by the current version of the system are the patients tests verifying the implications of the system in the therapy.

A terapia do espelho, técnica utilizada no tratamento de pacientes em reabilitação neurológica, tem mostrado bons resultados a um custo relativamente baixo. Nessa terapia, um espelho é colocado ao longo do plano sagital mediano do paciente entre os dois membros, superiores ou inferiores, com o intuito de transmitir estímulos visuais para o cérebro para induzir a ilusão dos membros em questão estarem se deslocando de forma síncrona. Considerando a simplicidade, os resultados obtidos e o baixo custo da terapia do espelho, neste trabalho exploramos recursos tipicamente disponíveis em dispositivos móveis do tipo tablet e smartphones para propor um modelo de acompanhamento remoto baseado na gravação e no compartilhamento de vídeos de sessões de terapia do espelho considerando dois tipos de usuários: terapeutas e pacientes. O modelo é apresentado na forma de um protótipo de um sistema de acompanhamento remoto de pacientes que utilizam a terapia do espelho em sua reabilitação. Especialistas avaliaram que o sistema apresenta grande potencial no auxilio à reabilitação de membros superiores, podendo ser utilizado por qualquer paciente em reabilitação pela terapia do espelho devido à sua facilidade de uso. Entre os trabalhos futuros viabilizados pela versão atual do sistema estão testes com pacientes em tratamento para verificação das implicações resultantes de sua utilização. / The mirror therapy technique used in the treatment of patients in neurological rehabilitation has shown good results in a relatively low cost. In this therapy, a mirror is placed along the median sagittal plane of the patient between the two limbs, higher or lower, in order to transmit visual stimuli to the brain to induce the illusion of the limbs are moving synchronously. Considering the simplicity, the results obtained and the low cost of mirror therapy in this work we explore resources available on mobile devices like tablet and smartphones to propose a remote monitoring model based on recording and sharing videos of mirror therapy sessions considering two types of users: therapists and patients. The model is presented as a prototype of a remote monitoring system of patients that use mirror therapy in their rehabilitation. Experts evaluated that the system presents great potential to aid in the rehabilitation of the upper limbs and may be used by any patient due to its ease of use. Among the future work made possible by the current version of the system are the patients tests verifying the implications of the system in the therapy.

Title: Cerebral projection of haptic contact via sLORETA imaging Objectives: The aim of this work is to evaluate changes in intracerebral source activity via sLORETA imaging during haptic stimulation of hands, while this contact is modified by a mirror illusion in comparison to calm state with open eyes. The work seeks to specify localization of such activity. Methods: Ten healthy volunteers aged 23-42 participated in the experiment. The electrical brain activity was detected with scalp EEG. The experiment was divided in 5 phases. First we measured the brain activity during calm state with open and with closed eyes, each for 5 minutes. Afterwards the subjects were seated at a table with a mirror occluding their right hand and reflecting their left hand. The brain activity was than recorded during 4 modifications of the experiment in duration of 2 minutes each. The first modification contained symmetrical haptic contact on both hands, modification 2 involved stimulation on the left hand only, during modification 3 the stimulus was applied on the right hand only and modification 4 had no tactile stimulus on neither side. The order of modifications for each individual was randomized. The EEG data were converted into sLORETA program, which allows to localize the source of the recorded brain activity...

Bakgrund: Majoriteten av de personer som genomgått ett amputationsingrepp drabbas av fantomsmärta. Trots att fantomsmärta är ett vanligt fenomen inom denna patientgrupp så är det ofta missförstått och det föreligger problem förknippade med hanteringen av fantomsmärtor. Tidigare forskning har visat inkonsekventa resultat som varierar från en forskare till en annan och komplexiteten med fantomsmärta har lett till behandlingsresultat med varierande effekt. I första hand har farmakologisk behandling använts, men många patienters smärta förblir refraktär mot farmakologiska medel och kräver därför andra alternativ. En alternativ behandling som först föreslogs i början på 1990-talet i vårdandet av fantomsmärta är spegelterapi. Spegelterapi kan användas som en omvårdnadsåtgärd för att smärtlindra fantomsmärtor och ska minska den amputerade kroppsdelens smärta.Syfte: Syftet med föreliggande litteraturstudie är att belysa effekten av spegelterapi som en omvårdnadsåtgärd för smärtlindring av fantomsmärtor.Metod: Metoden som använts är systematisk databassökning i databaserna PubMed och Cinahl. Litteraturstudien baseras på 10 vetenskapliga studier med kvantitativ studiedesign.Resultat: Litteraturstudiens syfte blev besvarat och kunde fastställa att spegelterapi har en smärtlindrande effekt för fantomsmärtor. Ett bifynd var att interventionen även bidrar till enförbättrad livskvalitet. Således delades resultatet in i två huvudteman: Spegelterapins smärtlindrande effekt utifrån olika smärtskattningsskalor samt påverkan på livskvaliteten. De frågor som ställts är om spegelterapi är en omvårdnadsåtgärd som kan användas i praktiken.Konklusion: Spegelterapi har en smärtlindrande effekt och minskar fantomsmärtor. Ett bifynd var att interventionen även bidrar till en förbättrad livskvalitet samt ökar välmåendet hos amputerade personer som lider av fantomsmärtor. Spegelterapi hade kunnat användas i praktiken efter att ha blivit optimerad och där en standardmetod för spegelterapi tagits fram. Däremot krävs det vidare forskning om spegelterapi. / Background: The majority of amputees suffer from phantom pain. Although phantom pain isa common phenomenon, it is often misunderstood and there are often problems with themanagement of phantom pain. Previous research has shown inconsistent results that varyfrom one researcher to another. The complexity with phantom limb pain has led to treatmentresults with varying effects. Primarily pharmaceuticals have been the main treatment. But many patients' discomfort still remains and the need for alternative treatment options isimperative. One alternative treatment is mirror therapy which was first suggested in thebeginning of the 1990’s century. Mirror therapy is supposed to reduce the phantom limb pain.Aim: The aim of this literature review is to highlight the effect of mirror therapy as a nursing treatment for reducing phantom limb pain.Method: The method that is used is a systematic database search in PubMed and Cinahl. The literature study is based on 10 scientific articles with a quantitative study design.Result: The literature study proved that mirror therapy is effective for reducing phantom limb pain. A secondary finding was the improvement of quality of life. Therefore the result was divided into two main themes: Change in phantom pain based on different pain assessment scales and the impact on the quality of life. Questions that were asked are whether mirror therapy is an intervention that can be used in the treatment of the phenomenon.Conclusion: Mirror therapy does reduce phantom pain in amputees. A secondary finding was that the intervention also contributes to a better quality of life and increases the well-being for the amputee. Mirror therapy could be practically applied after a standard method has been produced. However, further research is needed on mirror therapy.

Phantom limb pain may occur after the accidental removal or surgical amputation of a limb. Phantom limb pain is the experience of pain in the limb that is no longer present. The clinical management of phantom limb pain is essential in the overall reduction of patient rehabilitation and poor patient outcomes. A patient’s degree of phantom limb pain is influenced by their personal response to loss and pain and can have devastating effects to a person’s social performance, occupational role, family role, relationships, and involvement in activities or hobbies. Like most chronic pain, phantom limb pain decreases the quality of life. Not all amputees who suffer from chronic pain respond to traditional therapies. The purpose of this integrated review of the literature was to explore current research and determine the efficacy of mirror therapy in the treatment of Phantom limb pain in amputees. A database search of CINAHL, PubMed (MEDLINE), and OneSearch was conducted. Mirror therapy had no reported side effects, was inexpensive, and was capable of being practiced at home and at the bedside. Relevant findings in the literature revealed a significant decrease in phantom limb pain when using mirror therapy for more than 4 weeks. Although limited research on the use of mirror therapy as an intervention for amputees, existing research supports the efficacy of mirror therapy for the management of phantom limb pain. Nurses and healthcare providers need education on mirror therapy to advocate for their patients to ensure the best possible outcome and reduction of phantom limb pain. Further research on mirror therapy is needed.