Mirror Visual Feedback as a Therapeutic Modality in Complex Regional Pain Syndrome type I - A Randomized Controlled Trial (P9-6.001)

Abstract

<h3>Objective:</h3> To evaluate the efficacy of Mirror visual feedback as a therapeutic modality in the treatment of complex regional pain syndrome type I. <h3>Background:</h3> Complex regional pain syndrome (CRPS) type I is a clinical syndrome of variable course and unknown etiology characterized by neuropathic pain, vasomotor dysfunction of an extremity and autonomic abnormality. This condition is often the result of trauma, surgery or stroke. Its pathogenesis typically involves an exaggerated inflammatory response following injury to the extremities. There is growing evidence for the effectiveness of Mirror Therapy (MT) on pain reduction in patients with CRPS I. This mode of therapy has also the potential to reduce reliance on opioids to control pain and reduce healthcare costs. <h3>Design/Methods:</h3> Randomized Control Trial. The intervention group, (n13, patients undergoing MT), every day for 10 minutes were compared to the control group, (n14, not receiving MT). A crossover model was used at the end of each 6 weeks intervention period. <h3>Results:</h3> Patients with CRPS I undergoing MT were compared to patients not receiving MT demonstrated improvement in treatment parameters after a period of 6 weeks of intervention. Treatment parameters included: Active range of motion, dexterity, muscle strength, edema and Health-Related Quality of life. The retrograde spread of peripheral lesions to CNS may play a role in development of chronic pain (Ramachandran, 2012). Functional cortical reorganizations, have been shown to be present in subjects with CRPS I by positron emission tomography (PET) scan (Juottonen et al., 2002). A distorted representation of the limb in the cortex has been proposed as causing discrepancies between motor intention, proprioception, and vision. This distortion can be perceived as pain. <h3>Conclusions:</h3> Principles focused on neural feedback to the central nervous system, including Mirror Therapy is a cost effective treatment for pain reduction in CRPS I patients with potentials in reducing the burden of opioid use. <b>Disclosure:</b> Dr. Machac has received research support from Grant Agency of Charles University . Dr. Kakawand has nothing to disclose. Mrs. Chasakova has nothing to disclose. Lubomir Stepanek has nothing to disclose. Dr. Vejvalka has nothing to disclose. Dr. Cerny has nothing to disclose.