Elisabetta Ambron1,2, Laurel J Buxbaum3,4, Alexander Miller1, Harrison Stoll3, Katherine J Kuchenbecker5, H Branch Coslett1. 1. Department of Neurology, 6572Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. 2. 5972University of Delaware, Newark, DE, USA. 3. Moss Rehabilitation Research Institute, Elkins Park, Philadelphia, PA, USA. 4. Thomas Jefferson University, Philadelphia, PA, USA. 5. 28325Max Planck Institute for Intelligent Systems, Stuttgart, Baden-Württemberg, Germany.
Abstract
BACKGROUND: Phantom limb pain (PLP) is a common and in some cases debilitating consequence of upper- or lower-limb amputation for which current treatments are inadequate. OBJECTIVE: This small clinical trial tested whether game-like interactions with immersive VR activities can reduce PLP in subjects with transtibial lower-limb amputation. METHODS: Seven participants attended 5-7 sessions in which they engaged in a visually immersive virtual reality experience that did not require leg movements (Cool! TM), followed by 10-12 sessions of targeted lower-limb VR treatment consisting of custom games requiring leg movement. In the latter condition, they controlled an avatar with 2 intact legs viewed in a head-mounted display (HTC Vive TM). A motion-tracking system mounted on the intact and residual limbs controlled the movements of both virtual extremities independently. RESULTS: All participants except one experienced a reduction of pain immediately after VR sessions, and their pre session pain levels also decreased over the course of the study. At a group level, PLP decreased by 28% after the treatment that did not include leg movements and 39.6% after the games requiring leg motions. Both treatments were successful in reducing PLP. CONCLUSIONS: This VR intervention appears to be an efficacious treatment for PLP in subjects with lower-limb amputation.
BACKGROUND: Phantom limb pain (PLP) is a common and in some cases debilitating consequence of upper- or lower-limb amputation for which current treatments are inadequate. OBJECTIVE: This small clinical trial tested whether game-like interactions with immersive VR activities can reduce PLP in subjects with transtibial lower-limb amputation. METHODS: Seven participants attended 5-7 sessions in which they engaged in a visually immersive virtual reality experience that did not require leg movements (Cool! TM), followed by 10-12 sessions of targeted lower-limb VR treatment consisting of custom games requiring leg movement. In the latter condition, they controlled an avatar with 2 intact legs viewed in a head-mounted display (HTC Vive TM). A motion-tracking system mounted on the intact and residual limbs controlled the movements of both virtual extremities independently. RESULTS: All participants except one experienced a reduction of pain immediately after VR sessions, and their pre session pain levels also decreased over the course of the study. At a group level, PLP decreased by 28% after the treatment that did not include leg movements and 39.6% after the games requiring leg motions. Both treatments were successful in reducing PLP. CONCLUSIONS: This VR intervention appears to be an efficacious treatment for PLP in subjects with lower-limb amputation.
Authors: Kathryn Ziegler-Graham; Ellen J MacKenzie; Patti L Ephraim; Thomas G Travison; Ron Brookmeyer Journal: Arch Phys Med Rehabil Date: 2008-03 Impact factor: 3.966