The mirror therapy effectiveness as a part of physical rehabilitation program of servicemen after lower limb amputation due to mine-explosive injury

Abstract

Introduction. The article considers the possibilities of using the developed program of physical therapy for military personnel after amputation of the lower limbs due to mine-explosive injury with the use of kinesiotherapy and mirror therapy for phantom pain syndrome in the conditions of trauma hospitals. Mirror therapy is an additional method of motor rehabilitation and can be used both in a hospital and independently by the patient at home. The application of this method does not require significant time expenditure for the specialist or significant financial costs for the institution or the patient.
 Purpose. To determine the effectiveness of the physical therapy program for military personnel after amputation of the lower limbs due to mine-explosive injury.
 Materials and methods. The following methods were used to solve the tasks: analysis of scientific and methodical literature; methods of researching violations of structures, functions, limitations of activity and participation according to the ICF; generally accepted methods of medical statistics. In the course of the study, the condition of the patients was monitored for the effective construction of a physical therapy program, which included therapeutic exercises in the form of mirror therapy to reduce pain in the postoperative period. Also, this method was used to reduce pain in the stump.
 Result. The patients of the selected groups had a significant phantom pain syndrome, which increased in the evening, was evaluated by the visual-analog pain scale, and was from 7 to 9 points at rest. The VAS survey was conducted before and after the mirror therapy session. Peculiarities of mirror therapy: 1) to improve motor function: simple (basic) and functional movements are performed. Therapy is strictly individualized, the technique depends on the strength of the "mirror illusion" and the severity of motor function impairment; 2) for the purpose of correcting neglect, bilateral sensory stimulation is performed and observation of different hand positions in the mirror; 3) to reduce hypertension: unilateral movements are performed with a healthy limb; 4) to restore sensitivity: bilateral sensory stimulation is performed, that is, bilateral synchronous movements are performed; 5) to reduce the pain syndrome: unilateral motor and sensory exercises are performed with the healthy limb. The advantage of the technique of mirror therapy is its effectiveness, simplicity, safety and availability, the possibility of independent use by the patient. This technique corresponds to the basic principles of motor rehabilitation – high intensity and repetition of goal-oriented tasks in combination with feedback.
 Conclusions. Conducted studies using the mirror therapy method in people with amputation of the lower limb due to mine-explosive injury show that this method of physical therapy can be an effective way to reduce the level of phantom pain, pain in the stump. Also, during the application of mirror therapy, an increase in the amplitude of joint mobility is observed.