MachLachan Et Al (2004) - PLP CASE STUDY

Question 1

What was the aim of the case study?

Answer 1

To investigate whether mirror therapy could be used to treat a case of lower body phatom-limb pain

Question 2

Describe the sample

Answer 2

• 32 y/o man
• Alan (Alias)

Question 3

Can you describe the details of the case?

Answer 3

Alan had to recieve a life-saving leg amputation–due to the severity of his condition , he only became aware of his amputation 5 weeks later.
Within 2 days of conciousness– he began experiencing PLP and stump pain.

Question 4

Describe Alan’s Phantom Limb Pain

Answer 4

He described the phantom limp pain as growing in intensity throughout the day.
Morning- he felt pins and needles in his phantomb toes and felt two toes were crossed.
Afternoon- the pain grew severe and he eventually felt that his phantomb limb was shorter than the other, stretching backwards and toes pointing dowanwards- whilst in a cast,

Question 5

Describe his (first) treatment

Answer 5

• Pain medication
• Course of trans-cutenous electrical nerve simulation (TENS) treatment.
• Little effect
  He then tried mirror therapy- with the knowledge that it had not been used sucessfully with lower phantomb limp pain before.

Question 6

Describe Alan’s mirror treatment

Answer 6

1. MIRROR: Patient steated with a mirror positioned between his legs. Creating an illusion of having 2 legs.
2. MOVEMENT EXERCISES: Instructed to perform 10 movements, repeated them 10 times- such as pointing the foot up and downwards. They were carried out twice a day initially with a physiotherapist present.
3. PROGRESS: After a few days, he could perform the movements alone and eventually w/out a mirror (x4 daily)

Question 7

Results: Alan was asked to rate the phantom pain on a closed likert scale from 1=none 10=excruciating.
Did the mirror treatment reduce Alan’s phantomb limb pain?

Answer 7

Yes, He was instructed to rate his phantom pain on a closed likert scale from 1 (no pain) to 10 (excrutiating pain).
Before the treatment he rated the pain 5-9
After the treatment he rated the pain 0-2 (third week)

Question 8

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Did Alan’s sense of control over the phantom limb improve after the treatmemt?

Answer 8

Yes, he was instructed to rate his sense of control over his phantom limb on a closed likert scale from 0%=none 100%=full control.
Before the treatment- 0-3%
After: 25% to 30% sense of control

Question 9

What is the conclusion of the study?

Answer 9

• Mirror treatment is an effective treatment for PLP in lower limb amputations, improving pain relief and motor control.

Question 10

Strengths- MacLachan Et al (2004)

Answer 10

1. Detail: Case studys allow detailed information to be collected, allowing an accurate insight into a specific case.
2. RWA: 1st reported case of successful mirror therapy to treat LOWER PLP (which shows it can be benificial for others)

Question 11

Weakness of MachLachan et al (2004)

Answer 11

1. Low generalisability: As 1 ppts was studied in detail
2. Low reliability:Unlikely the unique circumstances of the study can be replicated

Question 12

MacLachan et al (2004)- issues and debates

Answer 12

• ideographic approach
• As it focuses on detailed, individualized observations
• rather than generalising findings across a population.

Question 13

What qualitative data was recorded in the study about Alan’s emotional state?

Answer 13

Felt emotional at seeing the reflected leg for the first time.