The treatment of phantom limb pain using immersive virtual reality: Three case studies

Purpose. This paper describes the design and implementation of a case study based investigation using immersive virtual reality as a treatment for phantom limb pain. Method. Three participants who experienced phantom limb pain (two with an upper-limb amputation, and one with a lower-limb amputation) took part in between 2 and 5 immersive virtual reality (IVR) sessions over a 3-week period. The movements of participants' anatomical limbs were transposed into the movements of a virtual limb, presented in the phenomenal space of their phantom limb. Results. Preliminary qualitative findings are reported here to assess proof of principle for this IVR equipment. All participants reported the transferal of sensations into the muscles and joints of the phantom limb, and all participants reported a decrease in phantom pain during at least one of the sessions. Conclusion. The authors suggest the need for further research using control trials.

[1]  V. Ramachandran,et al.  Synaesthesia in phantom limbs induced with mirrors , 1996, Proceedings of the Royal Society of London. Series B: Biological Sciences.

[2]  E. Brodie,et al.  Increased motor control of a phantom leg in humans results from the visual feedback of a virtual leg , 2003, Neuroscience Letters.

[3]  Malcolm MacLachlan,et al.  Mirror treatment of lower limb phantom pain: A case study , 2004, Disability and rehabilitation.

[4]  Vilayanur S. Ramachandran,et al.  Filling in Gaps in Perception: Part II. Scotomas and Phantom Limbs , 1993 .

[5]  Toby Howard,et al.  Can immersive virtual reality reduce phantom limb pain? , 2006, Studies in health technology and informatics.

[6]  J. Dolezal,et al.  Factors Associated with Use and Nonuse of an AK Prosthesis in a Rural, Southern, Geriatric Population , 1998 .

[7]  R. Melzack The McGill Pain Questionnaire: Major properties and scoring methods , 1975, PAIN.

[8]  P. Halligan,et al.  Simulating sensory-motor incongruence in healthy volunteers: implications for a cortical model of pain. , 2005, Rheumatology.

[9]  Daniel M. Wolpert,et al.  Forward Models for Physiological Motor Control , 1996, Neural Networks.

[10]  Joel Katz,et al.  Psychophysiological Contributions to Phantom Limbs * , 1992, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[11]  I. Mccoll,et al.  Phantom pain and sensation among British veteran amputees. , 1997, British journal of anaesthesia.

[12]  E. Brodie,et al.  Analgesia through the looking‐glass? A randomized controlled trial investigating the effect of viewing a ‘virtual’ limb upon phantom limb pain, sensation and movement , 2007, European journal of pain.

[13]  T. Jensen,et al.  Phantom limb, phantom pain and stump pain in amputees during the first 6 months following limb amputation , 1983, Pain.

[14]  D. Wolpert,et al.  Abnormalities in the awareness of action , 2002, Trends in Cognitive Sciences.

[15]  Steve Pettifer,et al.  Immersive Virtual Reality as a Rehabilitative Technology for Phantom Limb Experience: A Protocol , 2005, Cyberpsychology Behav. Soc. Netw..

[16]  C. Murray,et al.  An interpretative phenomenological analysis of the embodiment of artificial limbs , 2004, Disability and rehabilitation.

[17]  C. Murray,et al.  The Social Meanings of Prosthesis Use , 2005, Journal of health psychology.