Background
Phantom Pain happens when a limb is lost over the course of one's life or missing since birth. Essentially the brain generates pain and sensations for the missing limb. It is thought to be a psychological problem brought on by inherit physiological traits of the human brain. As a psychological problem it is subject to conscious and unconscious retraining. No treatment has as yet proven completely effective against phantom pain.
Mirror Therapy is one scientific clinically useful treatment for phantom pain developed by Vilayanur S. Ramachandran. It normally involves the use of a mirror box in later stages of rehabilitation.
A mirror box was featured on the American Television show "House" as a treatment for a war veteran. This clip illustrating the fictional use of a mirror box from that episode is inaccurate as it shows the mirror box as a instant cure all however it does accurately describe the process by which the mirror box is used. The clip may be considered somewhat offensive because House is always somewhat offensive.
In a mirror box the patient places the good limb into one side, and the stump into the other. The patient then looks into the mirror on the side with good limb and makes "mirror symmetric" movements, as a symphony conductor might, or as we do when we clap our hands. Because the subject is seeing the reflected image of the good hand moving, it appears as if the phantom limb is also moving. Through the use of this artificial visual feedback it becomes possible for the patient to "move" the phantom limb
-wikipedia
Mirror therapy has been proven by fMRI imaging to extort spatial attention.
In this first study on the neuronal correlates of the mirror illusion in stroke patients we showed that during bimanual movement the mirror illusion increases activity in the precuneus and the posterior cingulate cortex, areas associated with awareness of the self and spatial attention. By increasing awareness of the affected limb the mirror illusion might reduce learned non-use. The fact that we did not observe mirror-related activity in areas of the motor or mirror neuron system questions popular theories that attribute the clinical effects of mirror therapy to these systems.
-The neuronal correlates of mirror therapy: an fMRI study on mirror induced visual illusions in stroke patients
Attention (which is in this case not the same word as "pay attention") is as William James defined "withdrawal from some things in order to deal effectively with others.". Or as Shaun P. Vecera and Matthew Rizzo defined "The processes that permit an organism to choose some environmental inputs over others".
Spatial attention again defined by Shaun P. Vecera and Matthew Rizzo is "restricted to visuospatial attention—those attentional processes that select visual stimuli based on their spatial location".
Conclusion
Mirror therapy typically begins in a doctors office. A doctor trains a patient during in or out patient rehabilitation to look into the mirror and clench or move both the present and missing limb. After the technique has been proven useful to the individual it can be done at home without a doctor supervision and minimal training with the same overall results for both upper and lower body. Home based treatment results in nearly equal compliance.
It is my hypothesis that increased prevalence of virtual and augmented reality will allow for new kinds of spatial attention treatments for those with multiple amputations and chronic arthritis effecting both hands.
