A Clinical Trial of Mirror Treatment for Phantom Pain

NCT ID: NCT02912975

Last Updated: 2017-10-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

45 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-03-31

Study Completion Date

2017-07-15

Brief Summary

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A randomized controlled clinical to examine the effect of mirror therapy on phantom pain and residual limb pain in patients with traumatic transtibial amputations in Cambodia. The study will be conducted with a semi-crossover design using self-rated pain and function as the main result variables.

Detailed Description

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The study will be conducted in two phases: Firstly, the effects of mirror treatment (M) versus tactile treatment (T) will be compared in an open, randomized, semi-cross-over case-control design study. The second phase includes the responders from the initial treatment (M or T), the duration of the initial treatment effect will be observed, and the effect of a second round of similar treatment will be registered.

Phase one: The study patients will be randomized for M or T treatment. The main outcome variables will be gathered before the initial randomization and after an initial treatment period of three weeks. Non-responders (NR) will be allocated for an immediate second three-weeks treatment period of combined treatment (M+T); the responders (R) of the M, T and M+T enter the second phase of the study. The M+T non-responders discontinue the study.

Phase two: The responders will be observed for a period of maximum three months. When symptoms of phantom limb pain and/or CRPS resume, the patients will undergo a second treatment period with the same treatment as during phase one. The duration of the second treatment period will be maximum three weeks, but each patient may decide to interrupt the treatment at an earlier stage if he finds the effect satisfactory. The main outcome indicators will be gathered at the start and the end of the second treatment period.

The study closes at the end of the second treatment period. For both study phases the treatment effects will be compared between the strata and also inside each stratum, using each patient as his own control.

Conditions

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Phantom Limb Pain Complex Regional Pain Syndromes

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Mirror treatment

Five minutes treatment period twice a day for three weeks

Group Type EXPERIMENTAL

Tactile treatment

Intervention Type OTHER

In Tactile Treatment five different sensory stimuli is applied repeatedly to the skin of the affected part of the limb, in the actual case to the amputated limb from ten cm above the knee joint and distally to include the entire amputation stump: gentle touch with a feather, a brush, a piece of paper, a stone and a wooden stick. The stimuli are applied two times daily for five 5 minutes each time, one minute per material.

Tactile treatment

Tactile massage twice a day for three weeks

Group Type ACTIVE_COMPARATOR

Mirror treatment

Intervention Type OTHER

The mirror treatment: The patient sits on a chair, both knees in 90 degrees flexion, both lower limbs undressed, and places a mirror of 100 cm x 25 cm along the trans-tibial amputation stump so that the uninjured limb is reflected in the mirror while the amputation stump can not be seen by the patient. The patient then performs slow repeated movements of the foot from neutral position into maximum flexion while closely observing the reflected image of the uninjured limb - the illusion of a limb regained - in the mirror. The procedure goes on uninterrupted for five minutes in the morning and in the evening in the home of the study patient.

Interventions

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Mirror treatment

The mirror treatment: The patient sits on a chair, both knees in 90 degrees flexion, both lower limbs undressed, and places a mirror of 100 cm x 25 cm along the trans-tibial amputation stump so that the uninjured limb is reflected in the mirror while the amputation stump can not be seen by the patient. The patient then performs slow repeated movements of the foot from neutral position into maximum flexion while closely observing the reflected image of the uninjured limb - the illusion of a limb regained - in the mirror. The procedure goes on uninterrupted for five minutes in the morning and in the evening in the home of the study patient.

Intervention Type OTHER

Tactile treatment

In Tactile Treatment five different sensory stimuli is applied repeatedly to the skin of the affected part of the limb, in the actual case to the amputated limb from ten cm above the knee joint and distally to include the entire amputation stump: gentle touch with a feather, a brush, a piece of paper, a stone and a wooden stick. The stimuli are applied two times daily for five 5 minutes each time, one minute per material.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Present age \>16 years.
* Unilateral trans-tibial land mine amputation more than 12 months before entering the study.
* Suffering from phantom limb pain and/or CRPS-2.

Exclusion Criteria

* Amputation stump anomalies that require surgical reconstructions such as chronic infections, neuroma or major soft tissue deformities.
* Chronic alcoholism or drug abuse.
* Loss or deformities of limbs other than the actual amputation.
* Mental and/or cognitive disorders making self-reporting unreliable.
Minimum Eligible Age

16 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University Hospital of North Norway

OTHER

Sponsor Role collaborator

NCHADS - Ministry of Health of Cambodia

OTHER

Sponsor Role collaborator

Trauma Care Foundation, Norway

OTHER

Sponsor Role lead

Responsible Party

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Hans Husum

Clinic head

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Snorre Sollied, MD, PhD

Role: STUDY_DIRECTOR

Department of Intensive Care, University Hospital North Norway

Locations

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Trauma Care Foundation Cambodia

Battambang, , Cambodia

Site Status

Countries

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Cambodia

Other Identifiers

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975 905 055

Identifier Type: -

Identifier Source: org_study_id