Mirror visual feedback was originally devised as a therapeutic tool to relieve pain, perceived involuntarily movements, and paralysis in phantom limbs of people who had undergone amputations. Since this pioneering work was conducted in the mid-1990s, the technique has been applied to relieve pain and enhance movement in other chronic conditions such as stroke, complex regional pain syndrome (CRPS), other persistent pain conditions (such as carpal tunnel syndrome, rotator cuff syndrome), and even acute pain and movement restrictions from sprains (1,2,3,4, 5). To see a video clip demonstrating the use of Mirror Therapy on a swollen acute ankle sprain, please follow the link:

http://www.youtube.com/watch?v=FM1DKhKehfI&feature=related

 His rationale for this approach was based on the theory that involuntary movements and paralysis in a phantom limb arise from a combination of pre-amputation memories, such as the perception of a watch on the wrist, and a mismatch between output from the brain and sensory feedback (input to the brain). This mismatch, he argues, occurs because the motor cortex in the brain still perceives the limb to be present and continues to transmit motor commands (action plans like movement). Consequently, the individual feels their phantom limb moving (e.g., as a clenching of a phantom hand). Normally this activity would be reduced by error feedback sensors in the limb, but the part of the brain which monitors motor and sensory activity receives no sensory feedback from the amputated limb (5). Pain, therefore, may be induced by a conflict between visual feedback and lingering representations of the amputated limb in the brain. Mixed messages: the brain thinks it is moving the limb but the eyes tell it that it is not, and this creates conflict and confusion.

 The researchers hypothesized that by “giving back” the amputated limb, via a mirror illusion, they would provide, albeit artificially, the anticipated sensory feedback, thereby suppressing involuntary movements or enabling free movement of a previously paralyzed phantom limb (5). The mirror image gives the brain the illusion of visual feedback that the affected limb is intact and acting as commanded. Therefore, sensory input from the visual system matches the brain’s perception of what should be happening, thus a reduction in pain, muscle guarding, or even a reduction in paralysis.

 How is it done?

The typical approach to mirror therapy involves placing one limb behind a long mirror that is situated along the client’s midline while performing synchronous movement tasks with the unaffected limb and the phantom limb. What you are doing with the unaffected limb, you are attempting to do the same with the limb hidden behind the mirror. Meanwhile, you are situated so that you are looking in the mirror and can only see the unaffected side and its mirror image. The phantom or affected limb is out of sight behind the mirror.

 Depending on the body part that is affected, you may instead use a mirror box. In this instance, the affected limb is placed inside a mirrored box instead of being hidden behind a full length mirror. To see a video clip on YouTube by David Butler (a world renowned physiotherapist from Australia) for a further explanation and demonstration of Mirror Box Therapy, please follow the link:

http://www.youtube.com/watch?v=hMBA15Hu35M&feature=related

The fact that mirror therapy is able to reduce pain and movement dysfunction tells us that there is not just peripheral involvement in these responses (i.e.- nerve endings, inflammation, scar tissue, stiff joints, tight muscles, muscle imbalances, etc). This tells us that there is in fact a central processing effect that is controlling pain and movement dysfunction….THE BRAIN! Thus, treating a structure or body part locally is often not the whole answer. To be successful, one must address at least some of the treatment approach toward the central nervous system.

 Mirror therapy has opened the door for some exciting new research into the mechanisms that cause pain, and has allowed for the development of therapeutic techniques that address these mechanisms. In mid-April, I will be travelling to Nottingham, England, to attend the international Neurodynamics and Neuromatrix Conference. At this conference, there will be internationally recognized experts in the fields of brain and peripheral nerve plasticity, immunology and pain motor control, brain imaging, neurodynamics, stress physiology, education science and rehabilitation. I will be learning more about mirror therapy while there, as well as attending lectures and workshops on other various pain and neurophysiology approaches.

 REFERENCES

 1. Chan, B., Witt, R., Charrow, A., Howard, R., Pasquina, P., Heilman, K., & Tsao, J.

(2009). Mirror therapy for phantom limb pain. The New England Journal of

Medicine, 357, 2206-2207.

2. Moseley, L.G. (2006). Graded motor imagery for pathologic pain: A randomized

control trial. Neurology, 67, 2129-2134.

3. MacLachlan, M., McDonald, D., & Waloch, J. (2004). Mirror treatment of lower limb

phantom pain: A case study. Disability and Rehabilitation, 26, 901-904.

4. Darnell, B.D. (2009). Self-delivered home-based mirror therapy for lower limb phantom

pain. American Journal of Physical Medicine & Rehabilitation, 88, 78-81.

5. McCabe et al. (2008). Mirror Visual Feedback For The Treatment of Complex Regional Pain

Syndrome (Type 1). Current Pain and Headache Reports, 12, 103-107.

This is a tough one for me, because holistically, I view aspartame, and other artificial sweeteners as being exactly that – artificially produced, processed “food”, and I am a big supporter of whole, natural and organic (when possible) foods.  On the other hand, I see so many people who are struggling to lose weight, with sugar being their biggest nemesis.  They crave sweets daily, and are quick to satisfy their cravings with chocolate, candy, sugary drinks and other treats.  During weight loss efforts, these treats are often substituted with diet sodas and diet foods.

So in this case, it seems logical that changing to artificial sweeteners would lead directly to better health and weight loss since the non-diet counterparts are jammed with thousands of grams of sugar which undisputedly would lead to weight gain and other health problems.  I don’t believe this to always be the case, or at least not in such a black and white way.

I like to regard sugar as an addictive substance, like nicotine.  It has its sweet little hooks in a large majority of the North American population, and they are deeply implanted.  Staying with the smoking analogy, the more one smokes, the more one craves nicotine – the more sugary things we consume, the more we crave them.  And as with smoking, there are different approaches to quitting – some go cold turkey, never to smoke again; some are able to cut back to simply having an occasional cigarette (the social smoker); and some need a little help from other products, like the patch, or nicotine gum.  I liken diet pop/artificial sweeteners to the patch or gum.  Something that can be used in the interim to achieve a greater goal  - ideally eliminating pop and most other refined sugar products all together.

The following is an excerpt from an article written by nutritional health expert, Dr. Mercola, with some further information about Aspartame:

America's Deadliest Sweetener Betrays Millions, Then Hoodwinks You With Name Change

by Dr. Mercola | March 02 2010 |

Aspartame producer Ajinomoto is launching a new initiative that will rebrand the sweetener as “AminoSweet”.

Aspartame is used in many foods and beverages marketed as low calorie or sugar-free. However, its reputation has been clouded somewhat by studies that have investigated reports of ill effects.

Just to remind you, the side effects of aspartame can include:

• Headache
• Change in vision
• Convulsions and seizures
• Hallucination
• Nausea and vomiting
• Joint pain

It can cause many, many other problems as well.

Aspartame is the most controversial food additive in history, and its approval for use in food was the most contested in FDA history. In the end, the artificial sweetener was approved, not on scientific grounds, but rather because of strong political and financial pressure. After all, aspartame was previously listed by the Pentagon as a biochemical warfare agent!

It’s hard to believe such a chemical would be allowed into the food supply, but it was, and it has been wreaking silent havoc with people’s health for the past 30 years.

The truth is, it should never have been released onto the market, and allowing it to remain in the food chain is seriously hurting people – no matter how many times you rebrand it under fancy new names.

The Deceptive Marketing of Aspartame

Sold commercially under names like NutraSweet, Canderel, and now AminoSweet, aspartame can be found in more than 6,000 foods, including soft drinks, chewing gum, table-top sweeteners, diet and diabetic foods, breakfast cereals, jams, sweets, vitamins, prescription and over-the-counter drugs.

Aspartame producer Ajinomoto chose to rebrand it under the name AminoSweet, to “remind the industry that aspartame tastes just like sugar, and that it’s made from amino acids – the building blocks of protein that are abundant in our diet.”

This is deception at its finest: Begin with a shred of truth, and then spin it to fit your own agenda.

In this case, the agenda is to make you believe that aspartame is somehow a harmless, natural sweetener made with two amino acids that are essential for health and present in your diet already.

They want you to believe aspartame delivers all the benefits of sugar and none of its drawbacks. But nothing could be further from the truth.

How Aspartame Wreaks Havoc on Your Health

Did you know there have been more reports to the FDA for aspartame reactions than for all other food additives combined?

In fact, there are over 10,000 official complaints, but by the FDA’s own admission, less than 1 percent of those who experience a reaction to a product ever report it. So in all likelihood, the toxic effects of aspartame may have affected roughly a million people already.

While a variety of symptoms have been reported, almost two-thirds of them fall into the neurological and behavioral category consisting mostly of headaches, mood alterations, and hallucinations. The remaining third is mostly gastrointestinal symptoms.

Unfortunately, aspartame toxicity is not well-known by doctors, despite its frequency. Diagnosis is also hampered by the fact that it mimics several other common health conditions, such as:

How Diet Foods and Drinks CAUSE Weight Problems

In recent years, food manufacturers have increasingly focused on developing low-calorie foods and drinks to help you maintain a healthy weight and avoid obesity. Unfortunately, the science behind these products is so flawed, most of these products can actually lead to increased weight gain!

For example, researchers have discovered that drinking diet soda increases your risk of metabolic syndrome, and may double your risk of obesity – the complete opposite of the stated intention behind these “zero calorie” drinks.

The sad truth is that diet foods and drinks ruin your body's ability to count calories, and in fact stimulate your appetite, thus boosting your inclination to overindulge.

Unfortunately, most public health agencies and nutritionists in the United States recommend these toxic artificial sweeteners as an acceptable alternative to sugar, which is at best confusing and at worst harming the health of those who take their misguided advice.

Even More Toxic Dangers of Aspartame

Truly, there is enough evidence showing the dangers of consuming artificial sweeteners to fill an entire book -- which is exactly why I wrote Sweet Deception. If you or your loved ones drink diet beverages or eat diet foods, this book will explain how you've been deceived about the truth behind artificial sweeteners like aspartame and sucralose -- for greed, for profits, and at the expense of your health.

As mentioned earlier, almost two-thirds of all documented side effects of aspartame consumption are neurological.

One of the reasons for this side effect, researchers have discovered, is because the phenylalanine in aspartame dissociates from the ester bond. While these amino acids are indeed completely natural and safe, they were never designed to be ingested as isolated amino acids in massive quantities, which in and of itself will cause complications.

Additionally this will also increase dopamine levels in your brain. This can lead to symptoms of depression because it distorts your serotonin/dopamine balance. It can also lead to migraine headaches and brain tumors through a similar mechanism.

The aspartic acid in aspartame is a well-documented excitotoxin. Excitotoxins are usually amino acids, such as glutamate and aspartate. These special amino acids cause particular brain cells to become excessively excited, to the point that they die.

Excitotoxins can also cause a loss of brain synapses and connecting fibers. A review conducted in 2008 by scientists from the University of Pretoria and the University of Limpopo found that consuming a lot of aspartame may inhibit the ability of enzymes in your brain to function normally, and may lead to neurodegeneration.

According to the researchers, consuming a lot of aspartame can disturb:

·         The metabolism of amino acids

·         Protein structure and metabolism

·         The integrity of nucleic acids

·         Neuronal function

·         Endocrine balances

Furthermore, the ester bond in aspartame breaks down to formaldehyde and methanol, which are also toxic in their own right. So it is not surprising that this popular artificial sweetener has also been found to cause cancer.

…

How to Ditch Artificial Sweeteners, and Satiate Your Sweet Tooth

If you suffer from sweet cravings, it’s easy to convince yourself you’re doing the right thing by opting for a zero-calorie sweetener like aspartame. Please understand that you will do more harm than good to your body this way.

First, it’s important to realize that your body craves sweets when you’re not giving it the proper fuel it needs.

…

Acceptable Alternative Sweeteners

For those times when you just want a taste of something sweet, your healthiest alternative is Stevia. It’s a natural plant and, unlike aspartame and other artificial sweeteners that have been cited for dangerous toxicities, it is a safe, natural alternative that's ideal if you’re watching your weight, or if you’re maintaining your health by avoiding sugar.

It is hundreds of times sweeter than sugar and truly has virtually no calories.

I must tell you that I am biased; I prefer Stevia as my sweetener of choice, and I frequently use it. However, like most choices, especially sweeteners, I recommend using Stevia in moderation, just like sugar. In excess it is still far less likely to cause metabolic problems than sugar or any of the artificial sweeteners.

I want to emphasize, that if you have insulin issues, I suggest that you avoid sweeteners altogether, including Stevia, as they all can decrease your sensitivity to insulin.

Lo han is another sweetener like Stevia. It’s an African sweet herb that can also be used, but it’s a bit more expensive and harder to find.

So if you struggle with high blood pressure, high cholesterol, diabetes or extra weight, then you have insulin sensitivity issues and would benefit from avoiding ALL sweeteners.

But for everyone else, if you are going to sweeten your foods and beverages anyway, I strongly encourage you to consider using regular Stevia or Lo han, and toss out all artificial sweeteners and any products that contain them.