Metal bar prevents phantom limb motion: Case study of an amputation patient who showed a profound change in the awareness of his phantom limb

Abstract

This case report describes an amputee (patient A.S., a 60-year-old male forelimb amputee) who had an extraordinary experience with a phantom limb. He complained that he could not move the wrist of his phantom limb because a metal bar was perceived to be grasped by the hand. As a solution for removing the metal bar, we invited the patient to undergo mirror reflection-induced visual feedback therapy. The patient reported that the metal bar previously grasped by his hand was successfully removed from the phantom during the course of therapy. Interestingly, this experience was accompanied by profound changes in the EMG modulation in the residual wrist muscles. In this article, the possible mechanisms underlying this interesting phenomenon will be discussed.

Mirror Visual Feedback for Phantom Pain: International Experience on Modalities and Adverse Effects Discussed by an Expert Panel: A Delphi Study

“…Whether boredom of flexing and extending a limb for 30 minutes or subtle eye problems in a mostly elderly inpatient cohort may have played a role remains to be seen in further research. As a precaution, careful management is advised, especially because the literature mentioned vomiting as a possible outcome [11]. Whether the use of clothing can help to prevent these exacerbations needs to be investigated.…”

“…Chan et al, 10 2007 Two brief grief reactions Grünert-Plüss et al, 7 2008 Pain increase possible Casale et al, 16 2009 Dizziness, irritation, uneasiness Kawashima and Mita, 11 2009 Client vomited after an increasing feeling of nausea during the first session Darnall and Li, 14 2012 Boredom, increased depression, increase in phantom limb awareness, and phantom limb pain predetermined level of group consensus [18,19]. A number of advantages contributed to the choice of the Delphi Method in this study: feeding back the experts' responses from previous rounds validates and enlarges the data, and rapid clarification can be obtained [20].…”

“…These have never been compared and researched. Adverse effects are only rarely mentioned (Table 2) [7,10,11,[14][15][16] and are by no means thoroughly researched [4]. Only 1 article based on retrospective evaluation of patient records specifically discusses the frequent adverse effects of MVF experienced during treatment, which resulted in withdrawal from MVF [16].…”

“…Research has been conducted on the effectiveness of MVF with the identified problem of heterogeneous study designs [4][5][6]. The treatment plans vary to a great extent (Table 1) [7][8][9][10][11][12][13][14]. These have never been compared and researched.…”

The Effect of Mirror Therapy on the Management of Phantom Limb Pain

“…[1][2][3][4] PLP is one of the main causes of disability and distress among amputees, [5] and incidence of this phenomenon is up to 80 percent. [4,[6][7][8][9] Individual physiological, environmental, and psychological factors are involved in the etiology of PLP. [4,[10][11][12][13][14][15] Pathophysiology of PLP is not clearly known yet.…”