Phantom Limb Pain Marc Johnson

Rationale, Purpose, and Summary  Personal connection to this topic and this pain is common in a majority of amputees  The purpose of this study was to evaluate the successfulness of mirror therapy on amputee patients  This study looked at 80 amputees. 39 were part of the control and 41 part of mirror therapy.

Background Information  It is not fully understood why phantom limb pain is felt in amputees.  What is Mirror Therapy?  Mirror Therapy is not fully understood but there are many theories on why it has been successful for some patients.

Nursing Care Problem  Very prevalent in patients who undergo an amputation.  Lack of understanding.  Patient education is necessary.

Nursing Theory  Gate Control Theory  Written in 1965 by Melzack and Wall  It describes a gate located in the spinal cord that opens and closes which modifies the perception of pain  Melzack suggests that a psychological factor plays a role in pain perception.  Things that can close the gate  Medication  Being in a good mood  Concentrating on things other then the injury

Methods & Results  This study included 80 amputee patients (41 mirror therapy and 39 control group).  Participants were asked to perform 10 different exercise  Both the control and test groups had more control over pain. Mirror therapy does not reduce phantom limb pain any more than exercises on there own.

Critique  A larger test pool could have been used.  Grouping amputation types (Ex. All elective leg amputation in one group)  A follow up study to see if phantom pain returned on patients who found relief using mirror therapy.

Patient Care Design  Nurses would collaborate with:  A orthotic and prosthetic specialist  Pain specialist  Physical and occupational therapy  Therapist

Nursing Diagnosis  Chronic pain related to phantom limb sensation/pain  Nursing interventions  Education on the variety of therapies offered  Pain medications  Learn if there is a trigger to the pain along with location, duration, and level of pain

Advocate Role  This pain might be hard to understand and may be hard for the patient to explain but the pain is real and pain medication should be administered.  Every patient is different  Often pain is described as shooting, stabbing, burning, cramping.  Education

References Brodie, E., Whyte, A., Niven, C. (2007). Analgiea through the looking glass? A randomized controlled trial investigating the effects of viewing a virtual limb upon phantom limb pain, sensation and movement. European Journal of Pain, 11,