Mirror Therapy for Phantom Limb Pain at a Pediatric Oncology Institution.
Mirror therapy has not been reported for phantom limb pain (PLP) in pediatric oncology. Our aims are to describe the incidence and duration of PLP post-amputation, the duration of follow-up, pain scores and pain medications, and the differences between a group that received mirror therapy (MT) in addition to the standard treatment and a group that received only the standard treatment (non-MT).


METHODS
A retrospective review of patients' medical records from June 2009 to March 2015 was completed. The demographic characteristics, diagnoses and types of surgery were collected. The incidence and duration of PLP, duration of pain service follow-up, pain medications and pain scores were collected and analyzed using the Wilcoxon rank sum test.


RESULTS
Of 21 patients who underwent amputations (median age 13 years, range, 8-24 years), most common primary diagnosis osteosarcoma), 18 (85.7%) experienced PLP; 38.9% of them experienced PLP at 1 year post-amputation (11.1% of the MT group and 66.7% of the non-MT group). The MT group and non-MT groups experienced PLP for a mean (± SD) of 246 (± 200) days, and 541 (± 363) days, respectively (p=0.08). The mean (SD) opioid doses (mg/kg/day) in the MT and non-MT groups were 0.81 (± 0.99) and 0.33 (± 0.31), respectively; the mean (SD) gabapentin doses (mg/kg/day) were 40.1 (± 21) for the MT group and 30.5 (± 11.5) for the non-MT group.


CONCLUSIONS
MT in children with cancer-related amputations is associated with lower incidence of PLP at 1 year and shorter duration of PLP.
Department of Pediatric Medicine, Division of Anesthesiology, Director, Pain Management Service, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
Doralina L
DL
Anghelescu
St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
Cassandra N
CN
Kelly
Department of Anesthesiology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
Brenda D
BD
Steen
Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
Jianrong
J
Wu
Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
Huiyun
H
Wu
Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
Brian M
BM
DeFeo
Rehabilitation Services, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
Kristin
K
Scobey
Children's Anaesthesia, Women's and Children's Hospital, North Adelaide SA 5006, Australia.
Laura
L
Burgoyne
mirror therapy; pediatric oncology; phantom limb pain