Observation of limb movements reduces phantom limb pain in bilateral amputees

Tung, Monica; Murphy, Ian C.; Griffin, Sarah; Alphonso, Aimee L.; Hussey‐Anderson, Lindsey; Hughes, Katie E.; Weeks, Sharon R.; Merritt, Victoria C.; Yetto, Joseph M.; Pasquina, Paul F.; Tsao, Jack W.

doi:10.1002/acn3.89

Cited by 28 publications

(50 citation statements)

References 29 publications

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“…However, he could not imagine movement of the third and fourth fingers smoothly while he was facing the mirror and he felt pain. In a previous study, phantom limb pain in bilateral lower limb amputees decreased significantly by observing the experimenter's movement without moving the limb themselves . During the third stage, we selected a passive movement task so he could observe movement without moving his fingers.…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study, phantom limb pain in bilateral lower limb amputees decreased significantly by observing the experimenter's movement without moving the limb themselves. 29 During the third stage, we selected a passive movement task so he could observe movement withoutmovinghisfingers.Asaresult,hecouldimaginethe movement of the third and fourth fingers smoothly. The fourth stage was active movement as well as TMT.…”

Section: Discussionmentioning

confidence: 99%

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Successful Graded Mirror Therapy in a Patient with Chronic Deafferentation Pain in Whom Traditional Mirror Therapy was Ineffective: A Case Report

Mibu¹,

Nishigami

Tanaka³

et al. 2016

Pain Practice

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A 43-year-old man had deafferentation pain in his right upper extremity secondary to brachial plexus avulsion from a traffic accident 23 years previously. On our initial examination, he had severe tingling pain with numbness in the right fingers rated 10 on the numerical rating scale. The body perception of the affected third and fourth fingers was distorted in the flexed position. Although he performed traditional mirror therapy (TMT) for 4 weeks in the same methods as seen in previous studies, he could not obtain willed motor imagery and pain-alleviation effect. Therefore, we modified the task of TMT: Graded mirror therapy (GMT). GMT consisted of five stages: (1) observation of the mirror reflection of the unaffected side without imagining any movements of the affected side; (2) observation of the mirror reflection of the third and fourth fingers changing shape gradually adjusted from a flexed position to a extended position; (3) observation of the mirror reflection of passive movement; (4) motor imagery of affected fingers with observation of the mirror reflection (similar to TMT); (5) motor imagery of affected fingers without mirror. Each task was performed for 3 to 4 weeks. As a result, pain intensity during mirror therapy gradually decreased and finally disappeared. The body perception of the affected fingers also improved, and he could imagine the movement of the fingers with or without mirror. We suggested that GMT starting from the observation task without motor imagery may effectively decrease deafferentation pain compared to TMT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Successful Graded Mirror Therapy in a Patient with Chronic Deafferentation Pain in Whom Traditional Mirror Therapy was Ineffective: A Case Report

Mibu¹,

Nishigami

Tanaka³

et al. 2016

Pain Practice

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show abstract

“…Equivalent methods are used in patients with bilateral lower limbs amputation. Tung et al 91 have compared the effect of observing and mentally visualizing the movement of amputated segments. Patients who visually observed the movement had pain intensity decrease, as opposed to the other group, who had no difference.…”

Section: Phantom Limb Painmentioning

confidence: 99%

Physical rehabilitation to treat neuropathic pain

Souza¹,

Carqueja

Baptista³

2016

Revista Dor

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“…Comparatively, only one participant (17%) in the covered-mirror group and two participants (33%) in the mental visualization group had pain relief, with multiple individuals even reporting a worsening of their pain (10). A subsequent study by Tung et al investigated the role of mirror treatment for PLP in individuals with bilateral lower extremity amputations finding that the direct visual observation of another person's limb movements also effectively decreases pain (11). …”

Section: Introductionmentioning

confidence: 99%

“…It has been hypothesized that it is the visual feedback component of mirror therapy that disrupts the phantom pain experience, which is supported by studies demonstrating pain relief with mirror therapy as opposed to covered-mirror therapy or mental visualization practices alone (10, 11, 24, 25). The results from both mirror and observational therapy studies lead us to postulate that motor imagery created in a virtual environment may also be effective in treating PLP.…”

Section: Introductionmentioning

confidence: 99%

Clinical Trial of the Virtual Integration Environment to Treat Phantom Limb Pain With Upper Extremity Amputation

et al. 2018

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Background: Phantom limb pain (PLP) is commonly seen following upper extremity (UE) amputation. Use of both mirror therapy, which utilizes limb reflection in a mirror, and virtual reality therapy, which utilizes computer limb simulation, has been used to relieve PLP. We explored whether the Virtual Integration Environment (VIE), a virtual reality UE simulator, could be used as a therapy device to effectively treat PLP in individuals with UE amputation.Methods: Participants with UE amputation and PLP were recruited at Walter Reed National Military Medical Center (WRNMMC) and instructed to follow the limb movements of a virtual avatar within the VIE system across a series of study sessions. At the end of each session, participants drove virtual avatar limb movements during a period of “free-play” utilizing surface electromyography recordings collected from their residual limbs. PLP and phantom limb sensations were assessed at baseline and following each session using the Visual Analog Scale (VAS) and Short Form McGill Pain Questionnaire (SF-MPQ), respectively. In addition, both measures were used to assess residual limb pain (RLP) at baseline and at each study session. In total, 14 male, active duty military personnel were recruited for the study.Results: Of the 14 individuals recruited to the study, nine reported PLP at the time of screening. Eight of these individuals completed the study, while one withdrew after three sessions and thus is not included in the final analysis. Five of these eight individuals noted RLP at baseline. Participants completed an average of 18, 30-min sessions with the VIE leading to a significant reduction in PLP in seven of the eight (88%) affected limbs and a reduction in RLP in four of the five (80%) affected limbs. The same user reported an increase in PLP and RLP across sessions. All participants who denied RLP at baseline (n = 3) continued to deny RLP at each study session.Conclusions: Success with the VIE system confirms its application as a non-invasive and low-cost therapy option for PLP and phantom limb symptoms for individuals with upper limb loss.

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Observation of limb movements reduces phantom limb pain in bilateral amputees

Cited by 28 publications

References 29 publications

Successful Graded Mirror Therapy in a Patient with Chronic Deafferentation Pain in Whom Traditional Mirror Therapy was Ineffective: A Case Report

Successful Graded Mirror Therapy in a Patient with Chronic Deafferentation Pain in Whom Traditional Mirror Therapy was Ineffective: A Case Report

Physical rehabilitation to treat neuropathic pain

Clinical Trial of the Virtual Integration Environment to Treat Phantom Limb Pain With Upper Extremity Amputation

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