HAND/WRIST

Retraining the Brain using a Mirror Box

 

Sounds like a crazy idea huh? Well, when I read my first research article years ago on the topic, honestly that’s what I thought. Now, I am a true believer. After attending a hand symposium a few years ago where I learned two new hand protocols utilizing the mirror box, we introduced it into our practice here at Ortho RI, Foundry.

The mirror box was originally developed to help treat amputees suffering from phantom limb pain in 1996 by Dr V.S. Ramachandran, a world renowned neurologist and the Director of the Center for Brain and Cognition at the University of California, San Diego. Since then the mirror box has been incorporated into new treatment protocols for other diagnoses including complex regional pain syndrome (CRPS), stroke, neuropathic pain, arthritis, focal dystonia and hand rehabilitation.

The premise of the mirror box is fairly simple, tricking the brain by using the visual illusion of two healthy, pain free limbs. The affected limb is placed inside mirror box (where it cannot be seen) and the unaffected limb outside the box in front of the mirror. The patient then attempts to move both, in symmetrical movement patterns (exactly the same way) while looking into the mirror. The resulting visual illusion helps to retrain/ reprogram the brains perception of the affected body part.

I know this sounds a little far fetched but the results can be dramatic. Using the mirror box as part of certain protocols and in conjunction with other therapeutic interventions, we have had good success increasing pain free range of motion with many of our patients. We have used the mirror box with a variety of patients and found it to be most effective with patients whose pain is neurologically based and those who have chronic hand disabilities or are afraid to move for fear of re-injury or increased pain. It has not been effective with all the patients we have tried it with but it has definitely been helpful to the majority of them.  The key to success using the mirror box appears to be the patient “buying into” the theory behind it and being diligent about using a mirror box multiple times a day as part of their home program.
If you would like to see for yourself how it works check out one of these informational video’s on YouTube:
www.youtube.com/watch?v=YL_6OMPywnQ
www.youtube.com/watch?v=hMBA15Hu35M

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