Comparative Effects of Interventions on Phantom Limb Pain: A Network Meta-Analysis.

Area of Science:

• Neuroscience
• Pain Management
• Rehabilitation Medicine

Background:

• Phantom limb pain (PLP) is a prevalent form of chronic pain following amputation.
• Despite available treatments, PLP management remains a significant clinical challenge.
• Quantifying and ranking intervention efficacy is crucial for optimizing patient care.

Purpose of the Study:

• To systematically evaluate and rank the effectiveness of various interventions for phantom limb pain.
• To provide evidence-based guidance for clinicians treating PLP.
• To identify the most optimal therapeutic strategies for PLP.

Main Methods:

• A comprehensive literature search was conducted across major scientific databases (PubMed, MEDLINE, Embase, Web of Science, Cochrane).
• Network meta-analysis was employed to compare direct and indirect evidence among different PLP interventions.
• Twenty-two studies involving 662 patients and 13 interventions were included.

Main Results:

• Mirror therapy (MT) and MT combined with phantom exercise (PE) significantly reduced pain intensity compared to placebo.
• The MT+PE group showed a substantial decrease in pain (mean difference -6.05).
• Surface Under the Cumulative Ranking (SUCRA) analysis indicated MT+PE and neuromodulation techniques as the most effective interventions (SUCRA value 81.2).

Conclusions:

• Mirror therapy (MT) emerges as a highly effective treatment for phantom limb pain.
• Combining therapies, such as MT with PE or neuromodulation, can enhance therapeutic outcomes.
• These findings support the integration of evidence-based interventions for improved PLP management.