MIRROR BOX THERAPY

Executive Summary of Papers concerning Mirror Visualization Therapy and Mental Imagery

I suggest that the best starting point to look at why mirror box therapy and image visualization therapy works is to read :-

VS Ramachandran's article in Clinical Medicine vol 5 no 4 July August 05. (PDF File)

This article is a good introduction to the medicine and concepts, it covers mirror visual feedback and why it theoretically can help for phantom, stroke and crps.

I have split the papers into the clinical problems mirror therapy can be used for. Clearly the area requires significant further research.

My personal view on the therapy is that it certainly doesn't help everyone (what does?) however it can be very effective in the right patient. The therapy is very easy to teach and use, it has minimal side effect and the costs are solely down to the box costs and therapist's time.

I urge all my patients to do their normal physiotherapy using a mirror box. The have nothing to lose in doing so and certainly much to gain.

CRPS Papers

Randomized Controlled Trials

Graded Motor Imagery for pathological pain G.Lorimer Moseley (PDF File)

Neurology 2006; 67:2129 2134

Positive result for motor image therapy program in CRPS

Sensibly constructed trial by well known investigators published in good journal.

They used a graded program of visualization therapy (siding hands first, visualization of movement and then mirror therapy).

Graded motor imagery is effective for long-standing complex regional pain syndrome: a randomized controlled trial G.L. Moseley (PDF File)

Pain 108 (2004) 192-198

Positive result published in well-respected journal from sensible investigators.

Controlled Pilot Studies or Case Reports

A controlled pilot study of the utility of mirror visual feedback in the treatment of complex regional pain syndrome (type 1) (PDF File)

Rheumatology 2003;42:97-101

C. S. McCabe, R. C. Haigh, E. F. J. Ring, P. W. Halligan,

P. D. Wall and D. R. Blake

Trial showed positive result in early but not late CRPS, the P.D. Wall in this group is the late and great Patrick Wall of "Gate Theory of Pain Control" fame.