{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T18:38:34Z","timestamp":1766428714696,"version":"3.38.0"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Orthop Unfall"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Bis zu 80% der Patienten nach Amputation sind von Phantomschmerzen betroffen, f\u00fcr deren Entstehung Mechanismen der kortikalen Reorganisation diskutiert werden. Zu den nicht operativen Behandlungsverfahren dieser neuropathischen Schmerzen im Bereich des fehlenden K\u00f6rpergliedes z\u00e4hlt die Spiegeltherapie. Dabei soll durch Verwendung eines Spiegels beim Patienten die Illusion einer noch vorhandenen Extremit\u00e4t erzeugt werden. Diese Illusion soll Prozesse zur Wiederherstellung der urspr\u00fcnglichen Organisationsstruktur des somatosensorischen und motorischen Kortex anregen und so eine Schmerzreduktion erzielen. Ziel dieses systematischen Reviews ist, die Wirksamkeit der Spiegeltherapie zur Behandlung von Phantomschmerzen bei erwachsenen Patienten nach unilateralen Amputationen der unteren Extremit\u00e4t qualitativ zu analysieren.<\/jats:p><jats:p>Die Datenbanken Medline (PubMed), Physiotherapy Evidence Database (PEDro), Cochrane Library (Central) und OPENGREY werden systematisch bis zum 26. November 2020 durchsucht, gefolgt von fortlaufenden Suchen in diesen Datenbanken, um eine \u00dcbersicht von aktualisierter Literatur zu gew\u00e4hrleisten. Die Studienauswahl, die Datenextraktion sowie die Bewertung des Verzerrungspotenzials (Risk of Bias Tool [RoB]) der inkludierten Studien erfolgt durch 2 Gutachter unabh\u00e4ngig voneinander. Prim\u00e4rer Endpunkt ist die Schmerzintensit\u00e4t, sekund\u00e4re Endpunkte sind die Schmerzh\u00e4ufigkeit, die Schmerzdauer, die Aktivit\u00e4ten des t\u00e4glichen Lebens (ADL) sowie die Lebensqualit\u00e4t. Die Methodik des Reviews folgt den Empfehlungen der \u201ePreferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)\u201c sowie dem \u201eCochrane Handbook for Systematic Reviews of Interventions\u201c.<\/jats:p><jats:p>Von 234 identifizierten Artikeln werden 4 randomisierte kontrollierte Studien eingeschlossen. In allen Studien wird von einer Abnahme der Schmerzintensit\u00e4t durch die Spiegeltherapie berichtet, jedoch bestehen in nur 2 Studien signifikante Unterschiede zwischen der Spiegeltherapie und der Vergleichsintervention nach 4 Wochen (p\u00a0&lt;\u00a00,001; p\u00a0&lt;\u00a00,05). Dieser signifikante Unterschied hat in einer dieser Studien noch 3 und 6 Monate nach Ende der Therapie Bestand (p\u00a0&lt;\u00a00,001). Die Outcomes Schmerzh\u00e4ufigkeit, Schmerzdauer sowie ADL sind in einer Studie nach 4 und 10 Wochen Spiegeltherapie geringer als in der Vergleichsgruppe, jedoch ohne statistische Signifikanz (p\u00a0&gt;\u00a00,05). Nach 6 Monaten besteht hier hinsichtlich Schmerzdauer und ADL ein signifikanter Unterschied zugunsten der Spiegeltherapie (p\u00a0&lt;\u00a00,05). Zwei Studien kommen bez. des Unterschieds der Lebensqualit\u00e4t zwischen Interventionsgruppe und Vergleichsgruppe zu teils unterschiedlichen Resultaten.<\/jats:p><jats:p>Die Spiegeltherapie ist bei hoher Therapiefrequenz und Therapiedauer eine wirksame und nachhaltige Ma\u00dfnahme zur Verringerung der Phantomschmerzen bei Patienten nach unilateralen Amputationen der unteren Extremit\u00e4t. Eine \u00dcberlegenheit der Spiegeltherapie gegen\u00fcber den anderen Interventionen kann jedoch aufgrund qualitativ zu schwacher Evidenz nicht geschlussfolgert werden.<\/jats:p>","DOI":"10.1055\/a-2188-3565","type":"journal-article","created":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T00:29:15Z","timestamp":1700094555000},"page":"566-577","source":"Crossref","is-referenced-by-count":3,"title":["Wirksamkeit der Spiegeltherapie bei Patienten mit Phantomschmerzen nach Amputationen der unteren Extremit\u00e4t: eine systematische Literatur\u00fcbersicht"],"prefix":"10.1055","volume":"162","author":[{"given":"Lorena","family":"Scholl","sequence":"additional","affiliation":[{"name":"Fachbereich Gesundheitswesen, Therapiewissenschaften, Hochschule Niederrhein, Krefeld, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annette","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Fachbereich Gesundheitswesen, Therapiewissenschaften, Hochschule Niederrhein, Krefeld, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6233-9814","authenticated-orcid":false,"given":"Martin","family":"Alfuth","sequence":"additional","affiliation":[{"name":"Fachbereich Gesundheitswesen, Therapiewissenschaften, Hochschule Niederrhein, Krefeld, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,11,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1016\/s1474-4422(02)00074-1","article-title":"Phantom-limb pain: characteristics, causes, and treatment","volume":"1","author":"H Flor","year":"2002","journal-title":"Lancet Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2015","DOI":"10.1055\/s-2002-34360","article-title":"[Phantom pain after major amputation--etiology, treatment and prognosis]","volume":"127","author":"C Stremmel","year":"2002","journal-title":"Dtsch Med Wochenschr"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1055\/s-0029-1215547","article-title":"[Therapy of phantom limb pain]","volume":"44","author":"A Schwarzer","year":"2009","journal-title":"Anasthesiol Intensivmed Notfallmed Schmerzther"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/0304-3959(85)90090-9","article-title":"Immediate and long-term phantom limb pain in amputees: incidence, clinical characteristics and relationship to pre-amputation limb pain","volume":"21","author":"TS Jensen","year":"1985","journal-title":"Pain"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1016\/s0304-3959(97)00061-4","article-title":"The influence of preamputation pain on postamputation stump and phantom pain","volume":"72","author":"L Nikolajsen","year":"1997","journal-title":"Pain"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/0304-3959(83)90097-0","article-title":"Phantom limb, phantom pain and stump pain in amputees during the first 6 months following limb amputation","volume":"17","author":"TS Jensen","year":"1983","journal-title":"Pain"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"365","DOI":"10.36076\/ppj.2004\/7\/365","article-title":"Managing phantom pain","volume":"7","author":"L Manchikanti","year":"2004","journal-title":"Pain Physician"},{"key":"ref8","first-page":"227","article-title":"Prevalence and characteristics of chronic phantom limb pain among American veterans. 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