title: Development of a Clinical Framework for Mirror Therapy in Patients with Phantom Limb Pain: An Evidence-based Practice Approach.
abstract: OBJECTIVE
  To describe the development and content of a clinical framework for mirror therapy (MT) in patients with phantom limb pain (PLP) following amputation.
  
  
  METHODS
  Based on an a priori formulated theoretical model, 3 sources of data collection were used to develop the clinical framework. First, a review of the literature took place on important clinical aspects and the evidence on the effectiveness of MT in patients with phantom limb pain. In addition, questionnaires and semi-structured interviews were used to analyze clinical experiences and preferences of physical and occupational therapists and patients suffering from PLP regarding the application of MT. All data were finally clustered into main and subcategories and were used to complement and refine the theoretical model.
  
  
  RESULTS
  For every main category of the a priori formulated theoretical model, several subcategories emerged from the literature search, patient, and therapist interviews. Based on these categories, we developed a clinical flowchart that incorporates the main and subcategories in a logical way according to the phases in methodical intervention defined by the Royal Dutch Society for Physical Therapy. In addition, we developed a comprehensive booklet that illustrates the individual steps of the clinical flowchart.
  
  
  CONCLUSIONS
  In this study, a structured clinical framework for the application of MT in patients with PLP was developed. This framework is currently being tested for its effectiveness in a multicenter randomized controlled trial.
authors.affiliation: Department of Rehabilitation, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands.|Research Centre Autonomy and Participation of People with a Chronic Illness, Faculty of Health, Zuyd University of Applied Sciences, Heerlen, the Netherlands.
authors.forename: Andreas
authors.initials: A
authors.lastname: Rothgangel
authors.affiliation: Research Centre Autonomy and Participation of People with a Chronic Illness, Faculty of Health, Zuyd University of Applied Sciences, Heerlen, the Netherlands.|Research Centre Technology in Care, Faculty of Health, Zuyd University of Applied Sciences, Heerlen, the Netherlands.|Department Health Research Services, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands.
authors.forename: Susy
authors.initials: S
authors.lastname: Braun
authors.affiliation: Research Centre Technology in Care, Faculty of Health, Zuyd University of Applied Sciences, Heerlen, the Netherlands.|Department Health Research Services, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands.
authors.forename: Luc
authors.initials: L
authors.lastname: de Witte
authors.affiliation: Research Centre Autonomy and Participation of People with a Chronic Illness, Faculty of Health, Zuyd University of Applied Sciences, Heerlen, the Netherlands.|Department of Family Medicine, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands.
authors.forename: Anna
authors.initials: A
authors.lastname: Beurskens
authors.affiliation: Department of Rehabilitation, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands.|Adelante Centre of Expertise in Rehabilitation, Hoensbroek, the Netherlands.
authors.forename: Rob
authors.initials: R
authors.lastname: Smeets
mesh_terms: D000328:Adult; D000671:Amputation, Surgical / Q000009:adverse effects; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D019018:Imagery, Psychotherapy / Q000379:methods*; D008962:Models, Theoretical; D010591:Phantom Limb / Q000628:therapy*; D011795:Surveys and Questionnaires
keywords: amputation/adverse effects; imagery; mirror therapy; phantom limb pain; phantom limb/rehabilitation; physical Therapy; psychotherapy