In collaboration with an occupational therapist who works in a physical therapy private practice as a hand therapist, the following clinical questions were identified: Is mirror box therapy (MT) effective in reducing pain for patients with complex regional pain syndrome (CRPS); secondary to orthopedic injury or peripheral nerve damage in the upper extremity (UE)? What protocols and dosages are the most effective? A structured review of the literature identified 18 studies that focus on the use of MT for CRPS of the UE: one meta-analysis of systematic reviews, five systematic reviews (SR) and 12 individual studies of which four are not reviewed in the SRs. Research regarding the use of MT for CRPS shows positive effects on outcomes for pain reduction with CRPS Type I, both acute and chronic, and emerging evidence for increased functional use, sensation and decreased swelling. However, currently, evidence is considered of low quality due to small sample sizes and replication by the same research group. Protocols are highly variable and sometimes vague, but the most commonly researched protocol has been L. Moseley’s graded motor imagery (GMI) program.

The following knowledge translation products were selected in collaboration with the clinician: an in-service for clinicians and educational pamphlet for consumers. The clinician expressed satisfaction with the pamphlet and regret that we could not schedule the in-service. Further research evaluating the effectiveness of the different protocols and dosages available is recommended, as well as describing the experiences of both the clients and clinicians utilizing MT.

Publication Place

Tacoma, Washington


University of Puget Sound

Faculty Advisor

Sue Doyle, PhD, OTR/L, CFE

Project Chairperson

Publication Date



Capstone Project





Degree Program

Occupational Therapy

Degree Level

Master of Science


Occupational Therapy


University of Puget Sound

T9_Watson-page1.pdf (207 kB)
Capstone Approval