Characteristics of Phantom Limb Pain Alleviated with Virtual Reality Rehabilitation

Osumi, Michihiro; Inomata, Kazunori; Inoue, Yoshio; Otake, Yuko; Morioka, Shu; Sumitani, Masahiko

doi:10.1093/pm/pny269

Cited by 65 publications

(68 citation statements)

References 45 publications

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“…With the growing evidence that the level of the phantom limb's movement may be correlated with a cortical or subcortical reorganization, others have also suggested that improved phantom limb movement may be associated with pain reduction (49). However, in only one study was the phantom limb's movement actually measured quantitatively (20). Our data here also showed an improvement in movements of a phantom limb, quantified as a reduction in motor imagery time that was specific to the impaired limb.…”

Section: Discussionsupporting

confidence: 54%

“…For instance, Murray et al (37) conducted a case study with three patients over two to five sessions; Henriksen et al (38) investigated the feasibility of their VR environment with three upper limb amputees over seven sessions, and Chau and colleagues' case study involved only one PLP patient who participated in five sessions (39). Other VR studies involved a single session with one or more patients (20,(40)(41)(42)(43). One reason that prevents large sample sizes is that patients with PLP usually need the help of caregivers to travel, and most patients lived far from the research laboratory (not in the same province).…”

Section: Discussionmentioning

confidence: 99%

“…For the sensory intensity category, four of the five patients shared throbbing, sharp, and heavy experiences; the heavy sensation disappeared after the intervention. Further, we also categorized the pain qualities into "kinesthesia-related pain characteristics" (splitting, exhausting, burning, aching, throbbing, stabbing, sharp, shooting) and "somatosensory-related pain characteristics" (gnawing, fearful, cramping), as a previous study found that VR mirror-movement therapy specifically improved the kinesthesia-related pain characteristics (20). However, we found that these two categories improved to a similar extent, with an average 50.47% (SD = 31.57%) and 56.67% (SD = 36.51%) improvement, respectively (Figures 2D,E).…”

Section: Primary Outcomes-pain Ratingsmentioning

confidence: 99%

“…While critical reviews of MT find its analgesic effects are limited (17,18), some researchers believe that this limitation is because the limb movements are restricted to the mirror surface (14). Combining virtual reality (VR) with MT has provided a better sense of embodiment of the phantom limb, including a sense of ownership (SoO) and a sense of agency (SoA) (19,20) over their virtual body. In this article, the VR environment refers to immersive environments (21), where users are completely isolated from their physical surroundings and experience the three-dimensional virtual worlds through a stereographic head-mounted display (HMD).…”

Section: Introductionmentioning

confidence: 99%

“…The resulting analgesic effects are comparatively stronger than those from traditional MT (22). However, most researchers focused only on the short-term analgesic effect from one VR session (20,23). In fact, longitudinal studies on PLP used representations of a virtual limb displayed on a computer monitor instead of in immersive VR per se (24)(25)(26).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

“I Dreamed of My Hands and Arms Moving Again”: A Case Series Investigating the Effect of Immersive Virtual Reality on Phantom Limb Pain Alleviation

et al. 2020

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Phantom limb pain (PLP) is a type of chronic pain that follows limb amputation, brachial plexus avulsion injury, or spinal cord injury. Treating PLP is a well-known challenge. Currently, virtual reality (VR) interventions are attracting increasing attention because they show promising analgesic effects. However, most previous studies of VR interventions were conducted with a limited number of patients in a single trial. Few studies explored questions such as how multiple VR sessions might affect pain over time, or if a patient's ability to move their phantom limb may affect their PLP. Here we recruited five PLP patients to practice two motor tasks for multiple VR sessions over 6 weeks. In VR, patients "inhabit" a virtual body or avatar, and the movements of their intact limbs are mirrored in the avatar, providing them with the illusion that their limbs respond as if they were both intact and functional. We found that repetitive exposure to our VR intervention led to reduced pain and improvements in anxiety, depression, and a sense of embodiment of the virtual body. Importantly, we also found that their ability to move their phantom limbs improved as quantified by shortened motor imagery time with the impaired limb. Although the limited sample size prevents us from performing a correlational analysis, our findings suggest that providing PLP patients with sensorimotor experience for the impaired limb in VR appears to offer long-term benefits for patients and that these benefits may be related to changes in their control of the phantom limbs' movement.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Primary Outcomes-pain Ratingsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

“I Dreamed of My Hands and Arms Moving Again”: A Case Series Investigating the Effect of Immersive Virtual Reality on Phantom Limb Pain Alleviation

et al. 2020

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Addressing virtual reality misclassification: A hardware‐based qualification matrix for virtual reality technology

Takac

Collett

Conduit

et al. 2021

Clin Psychology and Psychoth

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Through its unique sensory synchronized design, virtual reality (VR) provides a convincing, user-centred experience of highly controllable scenarios. Importantly, VR is a promising modality for healthcare, where treatment efficacy has been recognized for a range of conditions. It is equally valuable across wider research disciplines. However, there is a lack of suitable criteria and consistent terminology with which to define VR technology. A considerable number of studies have misclassified VR hardware (e.g. defining laptops as VR), hindering validity and research comparisons. This review addresses these limitations and establishes a standardized VR qualification framework. As a result of a comprehensive theoretical and literature review, the hardware-based VR qualification matrix is proposed.The matrix criteria consist of (1) three-dimensional (3D) synchronized sensory stimulation; (2) degrees of freedom tracking; and (3) visual suppression of physical stimuli. To validate the model and quantify the current scale/diversity of VR misclassification, a 2019 sectional review of health-related studies was conducted.Of the 115 studies examined against standardized criteria, 35.7% utilized VR, 31.3% misclassified VR, 18.3% were considered quasi-VR, and 14.8% omitted critical specifications. The proposed model demonstrates good validity and reliability for qualifying and classifying VR.

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Physical therapeutic treatment for traumatic brachial plexus injury in adults: A scoping review

Chagas

Wanderley

Ferro

et al. 2021

PM&R

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Traumatic brachial plexus injury (BPI) is one of the most disabling injuries of the upper extremity, often requiring specialized treatment and a prolonged rehabilitation period. This scoping review was carried out to identify and describe the physical therapy modalities applied in the rehabilitation of adult individuals with BPI. Electronic databases, gray literature, and reference lists were searched, and studies meeting the following eligibility criteria were included: (a) interventions including any physical therapy modality; (b) individuals age ≥18 years old; and (c) a clinical diagnosis of BPI. The literature search yielded 681 articles of which 49 met the inclusion criteria and had their outcomes, treatment parameters, and the differences between conservative and pre‐ and postoperative treatment phases analyzed. The most commonly used physical therapy interventions were in the subfields of kinesiotherapy (ie, involving range of motion exercises, muscle stretching, and strengthening), electrothermal and phototherapy, manual therapy, and sensory re‐education strategies. Although several physical therapy modalities were identified for the treatment of BPI in this scoping review, the combination of low levels of evidence and the identified gaps regarding the treatment parameters challenge the reproducibility of such treatments in clinical practice. Therefore, future controlled clinical trials with clearer treatment protocols for individuals with BPI are needed.

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Characteristics of Phantom Limb Pain Alleviated with Virtual Reality Rehabilitation

Cited by 65 publications

References 45 publications

“I Dreamed of My Hands and Arms Moving Again”: A Case Series Investigating the Effect of Immersive Virtual Reality on Phantom Limb Pain Alleviation

“I Dreamed of My Hands and Arms Moving Again”: A Case Series Investigating the Effect of Immersive Virtual Reality on Phantom Limb Pain Alleviation

Addressing virtual reality misclassification: A hardware‐based qualification matrix for virtual reality technology

Physical therapeutic treatment for traumatic brachial plexus injury in adults: A scoping review

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