Effectiveness of Mirror Therapy for Phantom Limb Pain: A Systematic Review and Meta-analysis

Arch Phys Med Rehabil. 2022 May;103(5):988-997. doi: 10.1016/j.apmr.2021.07.810. Epub 2021 Aug 28.


Objective: To evaluate the effectiveness of mirror therapy (MT) for phantom limb pain (PLP).

Data sources: PubMed, EMBASE, Ovid MEDLINE, Scopus, Cochrane Library, Physiotherapy Evidence Database, CNKI, and WanFang Data were used to search for studies published up to March 31, 2021.

Study selection: Randomized controlled trials (RCTs) comparing the pain intensity of MT for PLP were performed. A total of 2094 articles were found. Among them, 10 were eligible for the final analysis.

Data extraction: The quality of the RCTs was assessed using the Physiotherapy Evidence Database (PEDro) scale by 2 independent reviewers. Outcome data were pooled according to follow-up intervals (1, 3, 6, and 12mo). Duration times were used as a basis for distinguishing subgroups. The primary evaluation was by visual analog scale. The PEDro scale was used to assess the methodological quality of studies.

Data synthesis: Meta-analysis revealed a statistically significant decrease in pain in the MT group vs the control group within 1 month (I2=0%; standardized mean difference [SMD]=-0.46, 95% confidence interval [CI], -0.79 to -0.13; P = .007). The patients with pain for longer than 1 year benefited more from MT (I2=0%; SMD=-0.46; 95% CI, -0.85 to -0.07; P = .02).

Conclusions: MT has beneficial effects for patients with PLP in the short-term, as evidenced by their improved pain scores. There was no evidence that MT had a long-term effect, but that may be a product of limited data. For patients with long-term PLP, MT may be an effective treatment.

Keywords: Amputation; Phantom limb pain; Phantom limbs; Phantom pain; Physical therapy; Rehabilitation.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Mirror Movement Therapy
  • Pain Measurement
  • Phantom Limb* / therapy
  • Physical Therapy Modalities
  • Treatment Outcome