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  • Mirror box

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    An occupational therapy assistant using mirror therapy to address phantom pain A mirror box is a box with two mirrors in the center (one facing each way), invented by Vilayanur S. Ramachandran to help alleviate phantom limb pain, in which patients feel they still have a limb after having it amputated. The wider use of mirrors in this way is known as mirror therapy or mirror visual feedback (MVF). In a mirror box the patient places the good limb into one side, and the residual limb into the other. The patient then looks into the mirror on the side with the 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, and to unclench it from potentially painful positions. Ramachandran (right) with his original mirror box

  • Targeted reinnervation

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    Targeted reinnervation enables amputees to control motorized prosthetic devices and to regain sensory feedback. The method was developed by Dr. Todd Kuiken at Northwestern University and Rehabilitation Institute of Chicago and Dr. Gregory Dumanian at Northwestern University Division of Plastic Surgery.

  • Phantom pain

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    Phantom pain sensations are described as perceptions that an individual experiences relating to a limb or an organ that is not physically part of the body. Limb loss is a result of either removal by amputation or congenital limb deficiency. However, phantom limb sensations can also occur following nerve avulsion or spinal cord injury. Sensations are recorded most frequently following the amputation of an arm or a leg, but may also occur following the removal of a breast, teeth, or an internal organ. Phantom limb pain is the feeling of pain in an absent limb or a portion of a limb. The pain sensation varies from individual to individual. Phantom limb sensation is any sensory phenomenon (except pain) which is felt at an absent limb or a portion of the limb. It has been known that at least 80% of amputees experience phantom sensations at some time of their lives. Some experience some level of this phantom pain and feeling in the missing limb for the rest of their lives. The term "phantom limb" was first coined by American neurologist Silas Weir Mitchell in 1871. Mitchell described that "thousands of spirit limbs were haunting as many good soldiers, every now and then tormenting them". However, in 1551, French military surgeon Ambroise Paré recorded the first documentation of phantom limb pain when he reported that, "For the patients, long after the amputation is made, say that they still feel pain in the amputated part".

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