Can immersive virtual reality reduce phantom limb pain?

This paper describes the design and implementation of a case-study based investigation using immersive virtual reality as a treatment for phantom limb pain. The authors' work builds upon prior research which has found the use of a mirror box (where the amputee sees a mirror image of their remaining anatomical limb in the phenomenal space of their amputated limb) can reduce phantom limb pain and voluntary movement to paralyzed phantom limbs for some amputees. The present project involves the transposition of movements made by amputees' anatomical limb into movements of a virtual limb which is presented in the phenomenal space of their phantom limb. The three case studies presented here provide qualitative data which provide tentative support for the use of this system for phantom pain relief. 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]  Craig D Murray,,et al.  Investigating the efficacy of a virtual mirror box in treating phantom limb pain in a sample of chronic sufferers , 2006 .

[3]  Grigore C. Burdea,et al.  Manipulation Practice for Upper-Limb Amputees Using Virtual Reality , 2005, Presence: Teleoperators & Virtual Environments.

[4]  J. A. Stevens,et al.  Using motor imagery in the rehabilitation of hemiparesis. , 2003, Archives of physical medicine and rehabilitation.

[5]  G. Lundborg,et al.  Training with a mirror in rehabilitation of the hand , 2005, Scandinavian journal of plastic and reconstructive surgery and hand surgery.

[6]  V S Ramachandran,et al.  Plasticity and functional recovery in neurology. , 2005, Clinical medicine.

[7]  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.

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

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

[10]  Grigore C. Burdea,et al.  A virtual-reality-based telerehabilitation system with force feedback , 2000, IEEE Transactions on Information Technology in Biomedicine.

[11]  James A. Flint,et al.  VIA: A Virtual Interface for the Arm of Upper-limb Amputees , 2003 .

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

[13]  Richard A. Sherman,et al.  Chronic phantom and stump pain among american veterans: results of a survey , 1984, Pain.

[14]  S L Wolf,et al.  Doing It with Mirrors: A Case Study of a Novel Approach to Neurorehabilitation , 2000, Neurorehabilitation and neural repair.

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

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

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

[18]  A. Sirigu,et al.  Illusory movements of the paralyzed limb restore motor cortex activity , 2003, NeuroImage.

[19]  Jonathan D. Cohen,et al.  Rubber hands ‘feel’ touch that eyes see , 1998, Nature.

[20]  Malcolm MacLachlan,et al.  Augmenting the Reality of Phantom Limbs: Three Case Studies Using an Augmented Mirror Box Procedure , 2006 .

[21]  Toby Howard,et al.  The treatment of phantom limb pain using immersive virtual reality: Three case studies , 2007, Disability and rehabilitation.