Relationship of prosthesis ownership and phantom limb pain: results of a survey in 2383 limb amputees

Abstract

Authorship has been granted only to those individuals who have contributed substantially to the manuscript.

Factors Associated With Prosthesis Embodiment and Its Importance for Prosthetic Satisfaction in Lower Limb Amputees

“…A recent systematic review on factors associated with prosthesis satisfaction in lower limb amputees (Baars et al, 2018) identified appearance, fit, and use of the prosthesis, medical issues of the residual limb, as well as properties of the device as important influencing factors, with sex, etiology of amputation, properties of the prosthesis socket, and the level of amputation representing crucial modulating variables. Further, Bekrater-Bodmann et al (2020) found that a younger age, a longer residual limb, an increased amount of time since amputation, a higher frequency of prosthesis use, and the type of prosthesis (modular vs. exoskeletal) were associated with higher prosthesis ownership-representing a sub component of embodiment (Longo et al, 2008)-in a sample of more than 1,300 lower limb amputees. Phantom and residual limb sensations have further been related to prosthesis embodiment (Kern et al, 2009;Giummarra et al, 2010;Bekrater-Bodmann et al, 2020).…”

“…Thus, embodied upper limb prostheses have recently been related to a stabilized body posture (Imaizumi et al, 2016) and improved motor planning (Gouzien et al, 2017). Furthermore, prosthesis embodiment has been epidemiologically related to reduced levels of post-amputation pain in both upper and lower limb amputees (Kern et al, 2009;Bekrater-Bodmann et al, 2020). Other results revealed prosthesis use-dependent brain plasticity, suggesting neural embodiment of the device (Lotze et al, 1999;Maimon-Mor and Makin, 2020).…”

“…Research on factors associated with the embodiment of a prosthesis is scarce. Epidemiological studies on samples of both upper and lower limb amputees reported associations between certain manifestations of prosthesis embodiment and the presence of non-painful phantom phenomena (Giummarra et al, 2010), the absence of phantom limb pain (Kern et al, 2009), as well as a younger age, a leg (vs. arm) amputation, a longer residual limb, a longer time since amputation, and the frequency of prosthesis use (Bekrater-Bodmann et al, 2020). However, the interpretation of these results is complicated by heterogeneous operationalizations of prosthesis embodiment experiences with unknown validity.…”

“…With the recently introduced Prosthesis Embodiment Scale (PEmbS; Bekrater-Bodmann, 2020), however, a psychometrically evaluated instrument for the assessment of prosthesis embodiment experiences is available, which might help to reliably identify factors associated with the perceptual integration of the prosthesis into an amputee's body representation. Moreover, since there is evidence for complex inter-relationships between individual and prosthesis variables (Bekrater-Bodmann et al, 2020), the often-used univariate statistical approaches (such as correlations for continuous data or tests for comparing the central tendency in subgroups) might be inappropriate to validly identify factors associated with prosthesis embodiment. Thus, multivariate statistical approaches are needed, which along with homogenous samples of sufficient sizes might help to identify factors associated with perceptual prosthesis embodiment.…”

Limb apparent motion perception: modification by tDCS, and clinically or experimentally altered bodily states

“…Additionally, we measured the integration of the prosthesis into the sensorimotor system, i.e., the subjective sense of prosthesis ownership, defined as the feeling of a prosthetic limb constituting an integral part of the body (Niedernhuber et al, 2018). Accumulating evidence shows that prosthesis ownership positively correlates with prosthesis use (Bekrater-Bodmann et al, 2021). On the other hand, prosthesis use seems to counteract the effects of sensorimotor deprivation from limb amputation, and may drive adaptive plasticity in the sensorimotor cortex (van den Heiligenberg et al, 2018).…”