{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T02:46:09Z","timestamp":1775270769808,"version":"3.50.1"},"reference-count":26,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Mil Health"],"accepted":{"date-parts":[[2018,9,12]]},"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:p>Up to 70 % of military amputees suffer phantom limb pain (PLP), which is difficult to treat. PLP has been attributed to cortical reorganisation and associated with impaired laterality. Repeated sessions of mirror therapy (MT) can benefit PLP; however, anecdotal evidence suggests one MT session could be effective. In a one-group pretest and post-test design, 16 UK military unilateral lower limb amputees (median age: 31.0, 95% CI 25.0 to 36.8 years) undertook one 10\u2009min MT session. Visual analogue scale (VAS) pain and laterality (accuracy and reaction time) measurements were taken pre-MT and post-MT. Median VAS PLP did not differ significantly between pre-MT 15 mm (2\u201353 mm) and post-MT 12 mm (1\u201331) (p=0.875) scores. For the amputated limb, there were no significant differences between pre-MT and post-MT scores for laterality accuracy, 95.3%, 95% CI 90.5% to 97.6% and 96.7%, 95% CI 90.0% to 99.4%, respectively (p=0.778), or reaction time, 1.42 s, 95% CI 1.11 to 2.11\u2009s and 1.42 s, 95% CI 1.08 to 2.02\u2009s, respectively (p=0.629). Laterality was also not different between limbs for accuracy, p=0.484,\u2009or reaction time, p=0.716, and did not correlate with PLP severity. No confounding variables predicted individual responses to MT. Therefore, one 10 min MT session does not affect laterality and is not effective as standard treatment for PLP in military lower limb amputees. However, substantial PLP improvement for one individual and resolution of a stuck phantom limb for another infers that MT may benefit specific patients. No correlation found between PLP and laterality implies associated cortical reorganisation may not be the main driver for PLP. Further research, including neuroimaging, is needed to help clinicians effectively target PLP.<\/jats:p>","DOI":"10.1136\/jramc-2018-001001","type":"journal-article","created":{"date-parts":[[2018,11,14]],"date-time":"2018-11-14T03:26:21Z","timestamp":1542165981000},"page":"146-150","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Effect of one session of mirror therapy on phantom limb pain and recognition of limb laterality in military traumatic lower limb amputees: a pilot study"],"prefix":"10.1136","volume":"166","author":[{"given":"Andrew P","family":"Wareham","sequence":"first","affiliation":[{"name":"Centre for Complex Trauma, Defence Medical Rehabilitation Centre Headley Court, Surrey, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4500-9327","authenticated-orcid":false,"given":"V","family":"Sparkes","sequence":"additional","affiliation":[{"name":"School of Healthcare Sciences, Arthritis Research UK Biomechanics and Bioengineering Centre, Cardiff University, Cardiff, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,11,14]]},"reference":[{"key":"2025081315290947000_166.3.146.1","first-page":"686","article-title":"Phantom limb phenomena: acute findings in British armed forces amputees","volume":"111","author":"Small","year":"2013","journal-title":"B J Anaesth"},{"key":"2025081315290947000_166.3.146.2","doi-asserted-by":"publisher","DOI":"10.1136\/jramc-2013-000069"},{"key":"2025081315290947000_166.3.146.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2016.01.063"},{"key":"2025081315290947000_166.3.146.4","doi-asserted-by":"publisher","DOI":"10.1136\/jramc-2013-000141"},{"key":"2025081315290947000_166.3.146.5","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1177\/175899830801300101","article-title":"Mirror therapy in hand rehabilitation: a review of the literature, the St Gallen Protocol for Mirror Therapy and Evaluation of a Case Series of 52 Patients","volume":"13","author":"Gr\u00fcnert-Pl\u00fcss","year":"2008","journal-title":"The British Journal of Hand Therapy"},{"key":"2025081315290947000_166.3.146.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc071927"},{"key":"2025081315290947000_166.3.146.7","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.jpain.2015.10.015","article-title":"The efficacy of movement representation techniques for treatment of limb pain--a systematic review and meta-analysis","volume":"17","author":"Thieme","year":"2016","journal-title":"J Pain"},{"key":"2025081315290947000_166.3.146.8","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ken170"},{"key":"2025081315290947000_166.3.146.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2006.06.002"},{"key":"2025081315290947000_166.3.146.10","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.sjpain.2017.01.007","article-title":"Trajectory of phantom limb pain relief using mirror therapy: Retrospective analysis of two studies","volume":"15","author":"Griffin","year":"2017","journal-title":"Scand J Pain"},{"key":"2025081315290947000_166.3.146.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.neulet.2010.09.062"},{"key":"2025081315290947000_166.3.146.12","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1007\/s00221-009-2067-z","article-title":"Effects of lower limb amputation on the mental rotation of feet","volume":"201","author":"Curtze","year":"2010","journal-title":"Exp Brain Res"},{"key":"2025081315290947000_166.3.146.13","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000249112.56935.32"},{"key":"2025081315290947000_166.3.146.14","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000236014.78230.77"},{"key":"2025081315290947000_166.3.146.15","doi-asserted-by":"publisher","DOI":"10.1002\/j.1532-2149.2011.00064.x"},{"key":"2025081315290947000_166.3.146.16","doi-asserted-by":"publisher","DOI":"10.1177\/1545968311433209"},{"key":"2025081315290947000_166.3.146.17","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/j.rehab.2016.04.001","article-title":"The effects of mirror therapy on pain and motor control of phantom limb in amputees: A systematic review","volume":"59","author":"Barbin","year":"2016","journal-title":"Ann Phys Rehabil Med"},{"key":"2025081315290947000_166.3.146.18","doi-asserted-by":"publisher","DOI":"10.1136\/jramc-2016-000648"},{"key":"2025081315290947000_166.3.146.19","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.mehy.2009.05.038","article-title":"Phantom limb pain--a phenomenon of proprioceptive memory?","volume":"73","author":"Anderson-Barnes","year":"2009","journal-title":"Med Hypotheses"},{"key":"2025081315290947000_166.3.146.20","doi-asserted-by":"publisher","DOI":"10.1097\/MRR.0b013e3283441e98"},{"key":"2025081315290947000_166.3.146.21","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awn124"},{"key":"2025081315290947000_166.3.146.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2010.02.020"},{"key":"2025081315290947000_166.3.146.23","doi-asserted-by":"crossref","first-page":"19","DOI":"10.3233\/NRE-2009-0496","article-title":"Sensorimotor training and cortical reorganization","volume":"25","author":"Flor","year":"2009","journal-title":"NeuroRehabilitation"},{"key":"2025081315290947000_166.3.146.24","doi-asserted-by":"publisher","DOI":"10.1038\/nrn1991"},{"key":"2025081315290947000_166.3.146.25","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/j.pmrj.2014.01.005","article-title":"Mirror visual feedback for phantom pain: international experience on modalities and adverse effects discussed by an expert panel: a delphi study","volume":"6","author":"Hagenberg","year":"2014","journal-title":"Pm R"},{"key":"2025081315290947000_166.3.146.26","doi-asserted-by":"crossref","DOI":"10.1016\/j.jphys.2014.08.006","article-title":"The PACT trial: PAtient Centered Telerehabilitation: effectiveness of software-supported and traditional mirror therapy in patients with phantom limb pain following lower limb amputation: protocol of a multicentre randomised controlled trial","volume":"61","author":"Rothgangel","year":"2015","journal-title":"J Physiother"}],"container-title":["BMJ Military Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jramc-2018-001001","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T01:49:57Z","timestamp":1775267397000},"score":1,"resource":{"primary":{"URL":"https:\/\/militaryhealth.bmj.com\/lookup\/doi\/10.1136\/jramc-2018-001001"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,14]]},"references-count":26,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,5,23]]},"published-print":{"date-parts":[[2020,6]]}},"alternative-id":["10.1136\/jramc-2018-001001"],"URL":"https:\/\/doi.org\/10.1136\/jramc-2018-001001","relation":{},"ISSN":["2633-3767","2633-3775"],"issn-type":[{"value":"2633-3767","type":"print"},{"value":"2633-3775","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11,14]]}}}