Katleho Limakatso1, Victoria J Madden2, Shamila Manie3, Romy Parker4. 1. Pain Management Unit, Department of Anaesthesia and Perioperative Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. 2. Pain Management Unit, Department of Anaesthesia and Perioperative Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa. 3. Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. 4. Pain Management Unit, Department of Anaesthesia and Perioperative Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. Electronic address: romy.parker@uct.ac.za.
Abstract
OBJECTIVE: To investigate whether graded motor imagery (GMI) is effective for reducing phantom limb pain (PLP) in people who have undergone limb amputations. DESIGN: A single-blinded randomised, controlled trial. SETTING:Physiotherapy out-patient departments in three secondary level hospitals in Cape Town, South Africa. PARTICIPANTS: Twenty-one adults (≥18 years) who had undergone unilateral upper or lower limb amputations and had self-reported PLP persisting beyond three months. INTERVENTIONS: A 6-week GMI programme was compared to routine physiotherapy. The study outcomes were evaluated at baseline, 6 weeks, 3 months and 6 months. OUTCOME MEASURES: The pain severity scale of the Brief Pain Inventory (BPI) was used to assess the primary outcome - PLP. The pain interference scale of the BPI and the EuroQol EQ-5D-5L were used to assess the secondary outcomes - pain interference with function and health-related quality of life (HRQoL) respectively. RESULTS: The participants in the experimental group had significantly greater improvements in pain than the control group at 6 weeks and 6 months. Further, the participants in the experimental group had significantly greater improvements than the control group in pain interference at all follow-up points. There was no between-group difference in HRQoL. CONCLUSION: The results of the current study suggest that GMI is better than routine physiotherapy for reducing PLP. Based on the significant reduction in PLP and pain interference within the participants who received GMI, and the ease of application, GMI may be a viable treatment for treating PLP in people who have undergone limb amputations. CLINICAL TRIAL REGISTRATION NUMBER: (PACTR201701001979279).
RCT Entities:
OBJECTIVE: To investigate whether graded motor imagery (GMI) is effective for reducing phantom limb pain (PLP) in people who have undergone limb amputations. DESIGN: A single-blinded randomised, controlled trial. SETTING: Physiotherapy out-patient departments in three secondary level hospitals in Cape Town, South Africa. PARTICIPANTS: Twenty-one adults (≥18 years) who had undergone unilateral upper or lower limb amputations and had self-reported PLP persisting beyond three months. INTERVENTIONS: A 6-week GMI programme was compared to routine physiotherapy. The study outcomes were evaluated at baseline, 6 weeks, 3 months and 6 months. OUTCOME MEASURES: The pain severity scale of the Brief Pain Inventory (BPI) was used to assess the primary outcome - PLP. The pain interference scale of the BPI and the EuroQol EQ-5D-5L were used to assess the secondary outcomes - pain interference with function and health-related quality of life (HRQoL) respectively. RESULTS: The participants in the experimental group had significantly greater improvements in pain than the control group at 6 weeks and 6 months. Further, the participants in the experimental group had significantly greater improvements than the control group in pain interference at all follow-up points. There was no between-group difference in HRQoL. CONCLUSION: The results of the current study suggest that GMI is better than routine physiotherapy for reducing PLP. Based on the significant reduction in PLP and pain interference within the participants who received GMI, and the ease of application, GMI may be a viable treatment for treating PLP in people who have undergone limb amputations. CLINICAL TRIAL REGISTRATION NUMBER: (PACTR201701001979279).
Authors: Kevin Pacheco-Barrios; Alejandra Cardenas-Rojas; Paulo S de Melo; Anna Marduy; Paola Gonzalez-Mego; Luis Castelo-Branco; Augusto J Mendes; Karen Vásquez-Ávila; Paulo E P Teixeira; Anna Carolyna Lepesteur Gianlorenco; Felipe Fregni Journal: Princ Pract Clin Res Date: 2021-12-27
Authors: Sandra Rierola-Fochs; Luz Adriana Varela-Vásquez; Jose Antonio Merchán-Baeza; Eduard Minobes-Molina Journal: Int J Environ Res Public Health Date: 2021-11-22 Impact factor: 3.390