Virtual reality therapies for phantom limb pain

Perry, Briana N.; Mercier, Catherine; Pettifer, Steve; Cole, Jonathan; Tsao, Jack W.

doi:10.1002/ejp.559

Cited by 25 publications

(22 citation statements)

References 17 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has been postulated that mirror therapy works by helping to reorganize the somatosensory cortex, as has been demonstrated on functional MRI [56]. Although individuals with bilateral limb loss may not be candidates for mirror therapy, the use of a virtual limb avatar may have similar benefits [57]. …”

Section: Pain Managementmentioning

confidence: 99%

Special Considerations for Multiple Limb Amputation

Pasquina

Miller

Carvalho

et al. 2014

Curr Phys Med Rehabil Rep

View full text Add to dashboard Cite

It has been estimated that more than 1.6 million individuals in the United States have undergone at least one amputation. The literature abounds with research of the classifications of such injuries, their etiologies, epidemiologies, treatment regimens, average age of onset (average age of amputation), and much more. The subpopulation that is often overlooked in these evaluations, however, is comprised of individuals who have suffered multiple limb loss. The challenges faced by those with single-limb loss are amplified for those with multiple limb loss. Pain, lifestyle adjustment, and quality of life return are just a few key areas of concern in this population. Along with amputations resulting from trauma, many individuals with multiple amputations have endured them as a result of dysvascular disease. Over recent years, amputations as a result of dysvascular disease have risen to comprise more than 80 % of new amputations occurring in the United States every year. This compares to just 54 % of total current prevalence. Those with diabetes comorbid with dysvascular disease make up 74 % of those with dysvascular amputations, and these individuals with diabetes comorbid with dysvascular disease have a 55 % chance of enduring an amputation of their contralateral limb within 2–3 years of their initial amputation. With the well-documented aging of the nation’s population and the similarly skyrocketing prevalence of dysvascular disease and diabetes, it can be expected that the number of individuals with multiple limb loss will continue to increase in the United States. This article outlines the recommended measures of care for this particular subpopulation, including pain management, behavioral health considerations, strategies for rehabilitation for various levels and variations of multiple limb loss, and the assistive technology and adaptive equipment that might be available for these individuals to best enable them to continue healthy, fulfilling lives following amputation.

show abstract

Section: Pain Managementmentioning

confidence: 99%

Special Considerations for Multiple Limb Amputation

Pasquina

Miller

Carvalho

et al. 2014

Curr Phys Med Rehabil Rep

View full text Add to dashboard Cite

show abstract

“…Support for Harris’ hypothesis comes from research with chronic pain patients showing that artificially creating sensorimotor disturbances can increase pain [5,6] and that artificially restoring sensorimotor congruence can sometimes decrease pain [7,8,9]. While Harris’ hypothesis has raised a lot of interest from a clinical perspective, the neural mechanisms underlying discordance” or “sensorimotor congruence” remain elusive.…”

Section: Introductionmentioning

confidence: 99%

Effect of Experimental Cutaneous Hand Pain on Corticospinal Excitability and Short Afferent Inhibition

et al. 2016

Self Cite

View full text Add to dashboard Cite

Sensorimotor integration is altered in people with chronic pain. While there is substantial evidence that pain interferes with neural activity in primary sensory and motor cortices, much less is known about its impact on integrative sensorimotor processes. Here, the short latency afferent inhibition (SAI) paradigm was used to assess sensorimotor integration in the presence and absence of experimental cutaneous heat pain applied to the hand. Ulnar nerve stimulation was combined with transcranial magnetic stimulation to condition motor evoked potentials (MEPs) in the first dorsal interosseous muscle. Four interstimulus intervals (ISI) were tested, based on the latency of the N20 component of the afferent sensory volley (N20−5 ms, N20+2 ms, N20+4 ms, N20+10 ms). In the PAIN condition, MEPs were smaller compared to the NEUTRAL condition (p = 0.005), and were modulated as a function of the ISI (p = 0.012). Post-hoc planned comparisons revealed that MEPs at N20+2 and N20+4 were inhibited compared to unconditioned MEPs. However, the level of inhibition (SAI) was similar in the PAIN and NEUTRAL conditions. This suggests that the interplay between pain and sensorimotor integration is not mediated through direct and rapid pathways as assessed by SAI, but rather might involve higher-order integrative areas.

show abstract

“…This is likely because these patients suffered from impaired movement representation (Garbarini et al, 2015). This mechanism has anecdotally proposed by other VR rehabilitation studies (Perry et al, 2014). Thus, the BCT is a valid assessment tool for quantifying movement representations of a limb.…”

Section: Discussionmentioning

confidence: 86%