Treatment Strategies for Phantom Limb Pain

Sturma, Agnes; Hruby, Laura A.; Vujaklija, Ivan; Østlie, Kristin; Farina, Dario

doi:10.1007/978-3-030-60746-3_12

Cited by 4 publications

(4 citation statements)

References 93 publications

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“…PLP does not yet have a defined pathophysiology and etiology [1]. There are several mechanisms involved in its onset, including central, spinal, or peripheral mechanisms, which explains the multimodal management needed, but also the many difficulties experienced during the treatment [2,3]. The incidence of PLP varies from 42.2 to 78.8% in the literature, and its prevalence is 45-85% [4].…”

Section: Introductionmentioning

confidence: 99%

Is mirror therapy associated with progressive muscle relaxation more effective than mirror therapy alone in reducing phantom limb pain in patients with lower limb amputation?

Brunelli

D’Auria

Stefani

et al. 2023

International Journal of Rehabilitation Research

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Mirror therapy is a widely used treatment for phantom limb pain (PLP) relief in patients with limb loss. Less common is progressive muscle relaxation (PMR), used mostly in other medical conditions (psychological, terminal cancer pain, etc). The purpose of this study is to evaluate the efficacy of a mirror therapy preceded by PMR intervention compared to mirror therapy preceded by unguided generic relaxation-mirror therapy in patients with lower limb amputation suffering from PLP. This pilot study was a single-blind, controlled, randomized trial. Thirty lower limb amputees suffering from PLP were recruited and randomly assigned to three groups respectively undergoing a PMR-mirror therapy rehabilitative intervention, generic relaxation-mirror therapy, and conventional physiotherapy (ConvPT). Selected items from Prosthesis Evaluation Questionnaire (PEQ) and the Brief Pain Inventory (BPI) were used to test the pain features at the beginning and 1 week after 3 weeks of intervention. A decrease of about 65% was found in the rate and duration of PLP at the PEQ in PMR-mirror therapy with respect to generic relaxation-mirror therapy (about 30%) and ConvPT (about 6%). A decrease of about 90% in intensity (worst and average) of PLP in PMR-mirror therapy when compared to generic relaxation-mirror therapy (about 45%) and ConvPT (about 20%) was found at the BPI. We preliminary concluded, albeit with limitations due to the small sample of patients, that mirror therapy can improve PLP when associated with PMR. Further studies are required to confirm that PMR could be an effective technique for more successful PLP management.

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Section: Introductionmentioning

confidence: 99%

Is mirror therapy associated with progressive muscle relaxation more effective than mirror therapy alone in reducing phantom limb pain in patients with lower limb amputation?

Brunelli

D’Auria

Stefani

et al. 2023

International Journal of Rehabilitation Research

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“…For such cases, the rehabilitation program is foreshortened. Still, we have experienced that regular training of controlled activation of the reinnervated muscles and a prosthesis can further improve the pain situation 32 . Here, shared decision-making is essential as some patients might wear a prosthesis for its potential to reduce pain in the long term 32 , while others might not be interested.…”

Section: Discussionmentioning

confidence: 99%

Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers

Sturma

Hruby

Boesendorfer

et al. 2021

JoVE

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“…Pemilihan anestesi lokal juga bisa diberikan dengan teknik blokade saraf menggunakan teknik epidural dan perineural. 41 Rekomendasi penatalaksanaan PLP terdiri atas obat-obatan nyeri neuropatik dengan lini pertama yaitu antidepresan (amitriptilin 0,35-0,4mg/kgBB/hari dan antikonvulsan (Gabapentin 30mg/kgBB/hari, Pregabalin 5mg/kgBB/hari), dengan lini kedua yaitu N-methyl-D-aspartate (NMDA) reseptor antagonis (ketamine 0,05-0,6mg/kgBB/hari) dan opioid (Morfin 2,5-5mg/hari).…”

Section: Isiunclassified

Phantom Limb Pain on Post-Surgical Amputation Osteosarcoma Children Patient

Bagus Pratama,

Jason Mikail Amper,

Gatra Hadimuti Wibowo

et al. 2022

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Osteosarcoma is a musculoskeletal malignancy that often occurs in pediatric patients requiring multidisciplinary management. Management in the form of amputation surgery (limb-salvage surgery) with a combination of chemotherapy or radiotherapy. Post-amputation complications that are often experienced by patient is postsurgical pain. Persistent Postsurgical Pain (PPSP) in pediatric patients is influenced by risk factors such as age, gender, preoperative preparation (pain intensity, anxiety, pain efficacy), intraoperative measures (site of surgery, potential for nerve damage, administration of analgesia regimens, technique of anesthesia), and postoperative management. The incidence of PPSP in osteosarcoma postamputation patients is related to Phantom Limb Syndrome with varying incidence and duration. This syndrome is a phenomenon that often occurs after post-amputation procedures in the form of sensation (Phantom Limb Sensation) or pain (Phantom Limb Pain) due to loss of part of the body. Phantom Limb Pain (PLP) is an effect and complication that occurs after amputation surgery in pediatric osteosarcoma patients. The PLP pathomechanism is related to the interaction of the Central Nervous System (Cortical Remapping Theory and Proprioceptive Theory) and the Peripheral Nervous System (Dorsal Root Ganglia and nocireceptor stimulation). Management of PLP consists of neuropathic pain medications such as antidepressants, opioids, anticonvulsants, N-methyl-D-aspartate (NMDA) receptor antagonists and other anesthetic agents.

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Treatment Strategies for Phantom Limb Pain

Cited by 4 publications

References 93 publications

Is mirror therapy associated with progressive muscle relaxation more effective than mirror therapy alone in reducing phantom limb pain in patients with lower limb amputation?

Is mirror therapy associated with progressive muscle relaxation more effective than mirror therapy alone in reducing phantom limb pain in patients with lower limb amputation?

Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers

Phantom Limb Pain on Post-Surgical Amputation Osteosarcoma Children Patient

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