Mirror therapy for phantom limb pain at a pediatric oncology institution

Background and Purpose/Objective: Mirror therapy (MT) has not been reported for phantom limb pain (PLP) in pediatric oncology. Our aims are to describe the incidence and duration of PLP postamputation, the duration of follow-up, pain scores and pain medications, and the differences between a group that received MT in addition to the standard treatment and a group that received only the standard treatment (non-MT). Methods: A retrospective review of patients' medical records from June 2009 to March 2015 was completed. Data on the demographic characteristics, diagnoses, and types of surgery were collected. The incidence and duration of PLP, duration of pain service follow-up, pain medications, and pain scores were collected and analyzed using the Wilcoxon rank sum test. Results: Of 21 patients who underwent amputations (median age = 13 years; range, 8-24 years; most common primary diagnosis osteosarcoma), 18 (85.7%) experienced PLP; 38.9% of them experienced PLP at 1 year postamputation (11.1% of the MT group and 66.7% of the non-MT group). The MT and non-MT groups experienced PLP for a mean (SD) of 246 (200) days and 541 (363) days, respectively (P =.08). The mean (SD) opioid doses (mg/kg per day) in the MT and non-MT groups were 0.81 (0.99) and 0.33 (0.31), respectively; the mean (SD) gabapentin doses (mg/kg per day) were 40.1 (21) for the MT group and 30.5 (11.5) for the non-MT group. Conclusion: Mirror therapy in children with cancer-related amputations is associated with lower incidence of PLP at 1 year and shorter duration of PLP.