Mirror Therapy in Hand Rehabilitation: A Review of the Literature, the St Gallen Protocol for Mirror Therapy and Evaluation of a Case Series of 52 Patients

Abstract

Over the past ten years, mirror visual feedback has been reported as a new treatment modality for chronic pain by several authors using different methods. Pioneering studies of mirror therapy for different clinical problems and its application in key studies are presented. Mirror therapy (MT) involves the use of the non-injured side reflected in the mirror, thus giving an illusion of function in a missing or injured side. Some neurophysiological aspects are illuminated to get an impression of what mirror therapy causes in the brain. The first aim of this study was to look at the available literature and to study the usefulness of MT in different diagnoses in hand rehabilitation as a basis for developing the St Gallen protocol for mirror therapy, which has been used with 52 patients since the end of 2005. The secondary aim is to describe the St Gallen protocol and present the results from the cases of 52 patients treated with MT. Two selected case studies provide a more detailed illustration of the method of application. Our experience confirms the positive effect of MT, specifically in reducing pain, improving function of movements and sensibility already reported in the literature.