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

BACKGROUND: Phantom limb pain (PLP) is a common type of chronic pain that occurs after limb amputation. Many treatment approaches are available; however, the treatment of PLP is still a challenge. This study aimed to quantify and rank the efficacy of interventions for phantom limb pain. METHODS: A comprehensive literature search was performed using the databases of PubMed, MEDLINE, Embase, Web of Science, and Cochrane. A network meta-analysis was applied to formulate direct and indirect comparisons among interventions for PLP. RESULTS: Twenty-two studies comprising 662 patients and 13 different interventions were included in this study. The mirror therapy (MT) (-1.00; 95% confidence interval, -1.94 to -0.07) and MT + phantom exercise (PE) (-6.05; 95% confidence interval, -8.29 to -3.81) group presented significantly lower pain intensity compared with placebo. In SUCRA (surface under the cumulative ranking curve) analysis, the MT+PE and neuromodulation techniques groups had the highest SUCRA value (81.2). CONCLUSIONS: Our results suggest that MT is the most optimal treatment for PLP, and a combination of therapies would enhance the therapeutic effect

Automated summary

A network meta-analysis was conducted to rank and quantify the efficacy of interventions for phantom limb pain. The study found that mirror therapy is the most optimal treatment for PLP, and a combination of therapies would enhance the therapeutic effect.