Interactions Between the Phantom Limb Sensations, Prosthesis Use, and Rehabilitation as Seen by Amputees and Health Professionals

Abstract

There is evidence of interaction between phantom limb sensation (PLS) and upper limb prosthesis use, but the nature of this interaction remains unclear. The objective of this study is to investigate the view of prosthesis users and health professionals working with upper limb amputees regarding interaction between PLS, prosthesis use, and rehabilitation services.Twelve upper limb prosthesis users and four health professionals participated in a semistructured one-on-one interview, assessing the perceived interaction between phantom limb phenomena, prosthesis use, and rehabilitation. Prosthesis users participating in this study perceived no long-term changes in their PLS and phantom limb pain (PLP) as they have been wearing their prosthesis. However, many of them reported transient changes in PLP while wearing and using their prosthesis. All myoelectric prosthesis users reported that PLS influences the control of their prosthesis, either positively or negatively. None of the body-powered prosthesis users reported this type of interaction. Even if prosthesis users and health professionals agreed to say that although PLS and PLP are documented and sometimes targeted during rehabilitation (mainly for pain control), interaction between PLS and the prosthesis is rarely considered. Prosthesis users and health professionals have the perception that PLSs interact with prosthesis use, especially in the case of a myoelectric prosthesis. Further research is needed to characterize the nature of this interaction. Moreover, health professionals need to take this type of interaction into account more systematically in their rehabilitation program. (J Prosthet Orthot. 2012; 24:25-33.) KEY INDEXING TERMS: phantom limb pain, upper limb amputation, myoelectric prosthesis, body powered prosthesis, occupational therapist, prosthetist, rehabilitation are affiliated with the Centre de recherche interdisciplinaire en réadaptation et intégration sociale (CIRRIS) and

Impact of Michelangelo prosthetic hand: Findings from a crossover longitudinal study

“…In particular, note that two of the participants, despite the painful sensation, reported that the coincidence of phantom limb movements with prosthesis movements helped them to better control the artificial hand. This confirmed previous findings available in the literature [44].…”

Differences in myoelectric and body-powered upper-limb prostheses: Systematic literature review

“…Investigators postulated increased phantom pain causing decreased prosthesis use is unlikely because no patient reported increased phantom pain with prosthetic use or cited pain as a reason for prosthetic discontinuance. Using qualitative and survey methodologies, Bouffard et al evaluated a sample of 12 persons with upperlimb amputation (85% transradial, 15% transhumeral) [36]. Their findings were not in agreement with those of Lotze et al regarding strictly beneficial effects of prosthetic use, specifically MYO use, relative to phantom limb pain.…”

“…Phantom limb pain is any sensation in the amputated part of the arm that is perceived as painful [36,54]. Phantom limb pain may begin immediately postamputation and is problematically high, with an estimated 50 percent prevalence in persons with upper-limb amputation [15].…”

Literature Review on Needs of Upper Limb Prosthesis Users

“…The seven selected relevant studies are Kyberd and Hill ( 2007 ), Biddiss et al ( 2007 ), Jang et al ( 2011 ), Pylatiuk et al ( 2007 ), Østlie et al ( 2012 ), Bouffard et al ( 2012 ), and Lucchetti et al ( 2015 ). Special attention has been dedicated to the comparative analysis of user experience with myoelectric, electric, body-powered and passive upper limb prostheses, independently of the level of limb loss.…”