Case Report: Virtual reality training for phantom limb pain after amputation
Several reports have demonstrated the effectiveness of neurorehabilitation, such as mirror therapy or virtual reality, in treating phantom limb pain (PLP). This case study describes the effect of virtual reality training (VRT) on severe, long-term PLP and upper limb activity on the amputated side in...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-12-01
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| Series: | Frontiers in Human Neuroscience |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnhum.2023.1246865/full |
| _version_ | 1827620069813780480 |
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| author | Manabu Yoshimura Hiroshi Kurumadani Junya Hirata Katsutoshi Senoo Kozo Hanayama Toru Sunagawa Kosuke Uchida Akio Gofuku Kenji Sato |
| author_facet | Manabu Yoshimura Hiroshi Kurumadani Junya Hirata Katsutoshi Senoo Kozo Hanayama Toru Sunagawa Kosuke Uchida Akio Gofuku Kenji Sato |
| author_sort | Manabu Yoshimura |
| collection | DOAJ |
| description | Several reports have demonstrated the effectiveness of neurorehabilitation, such as mirror therapy or virtual reality, in treating phantom limb pain (PLP). This case study describes the effect of virtual reality training (VRT) on severe, long-term PLP and upper limb activity on the amputated side in a patient who underwent digit amputation 9 years prior. A woman in her 40 s underwent amputation of 2–5 fingers 9 years prior due to a workplace accident. She experienced persistent pain in the palms of her hand near the amputation sites. A single case design (ABA’B’) was applied. Periods A and A’ were set as periods without VRT intervention, and Periods B and B’ were set as periods with VRT intervention. Periods A, B, A’, and B’ lasted 4, 10, 8, and 10 weeks, respectively. VRT was a task during which visual stimulation and upper limb movements were linked. The task consisted of catching a rolling ball in the display with a virtual hand, operated with both hands using a controller. VRT was performed once every 2–4 weeks for 30 min. Pain intensity was assessed using the short-form McGill Pain Questionnaire-2. Bilateral upper limb activity was measured continuously for 24 h using a triaxial accelerometer attached to the right and left wrist joints. The pain intensity was 147/220 points during Period A, 128 points during Period B, 93 points during Period A’, and 100 points during Period B’, showing a gradual decrease. Upper limb activity occurred mainly on the intact side during Periods A and B, whereas the activity on the amputated side increased 2-fold after Period A’, and both upper extremities were used equally. Virtual reality training resulted in reduced pain intensity and increased activity in the upper limb. VRT may have induced reintegration of the sensory-motor loop, leading to a decrease in the PLP intensity. The upper limb activity on the amputated side may have also increased with the pain reduction. These results suggest that VRT may be valuable in reducing severe, long-term PLP. |
| first_indexed | 2024-03-09T10:41:26Z |
| format | Article |
| id | doaj.art-4d828c6611b44435a230b26dadb126c5 |
| institution | Directory Open Access Journal |
| issn | 1662-5161 |
| language | English |
| last_indexed | 2024-03-09T10:41:26Z |
| publishDate | 2023-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Human Neuroscience |
| spelling | doaj.art-4d828c6611b44435a230b26dadb126c52023-12-01T13:41:37ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612023-12-011710.3389/fnhum.2023.12468651246865Case Report: Virtual reality training for phantom limb pain after amputationManabu Yoshimura0Hiroshi Kurumadani1Junya Hirata2Katsutoshi Senoo3Kozo Hanayama4Toru Sunagawa5Kosuke Uchida6Akio Gofuku7Kenji Sato8Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Okayama, JapanGraduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, JapanFaculty of Rehabilitation, Kawasaki University of Medical Welfare, Okayama, JapanFaculty of Rehabilitation, Kawasaki University of Medical Welfare, Okayama, JapanDepartment of Rehabilitation Medicine, Kawasaki Medical School, Okayama, JapanGraduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, JapanQuality Assurance Center, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, JapanQuality Assurance Center, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, JapanDepartment of Anesthesiology & ICM, Kawasaki Medical School, Okayama, JapanSeveral reports have demonstrated the effectiveness of neurorehabilitation, such as mirror therapy or virtual reality, in treating phantom limb pain (PLP). This case study describes the effect of virtual reality training (VRT) on severe, long-term PLP and upper limb activity on the amputated side in a patient who underwent digit amputation 9 years prior. A woman in her 40 s underwent amputation of 2–5 fingers 9 years prior due to a workplace accident. She experienced persistent pain in the palms of her hand near the amputation sites. A single case design (ABA’B’) was applied. Periods A and A’ were set as periods without VRT intervention, and Periods B and B’ were set as periods with VRT intervention. Periods A, B, A’, and B’ lasted 4, 10, 8, and 10 weeks, respectively. VRT was a task during which visual stimulation and upper limb movements were linked. The task consisted of catching a rolling ball in the display with a virtual hand, operated with both hands using a controller. VRT was performed once every 2–4 weeks for 30 min. Pain intensity was assessed using the short-form McGill Pain Questionnaire-2. Bilateral upper limb activity was measured continuously for 24 h using a triaxial accelerometer attached to the right and left wrist joints. The pain intensity was 147/220 points during Period A, 128 points during Period B, 93 points during Period A’, and 100 points during Period B’, showing a gradual decrease. Upper limb activity occurred mainly on the intact side during Periods A and B, whereas the activity on the amputated side increased 2-fold after Period A’, and both upper extremities were used equally. Virtual reality training resulted in reduced pain intensity and increased activity in the upper limb. VRT may have induced reintegration of the sensory-motor loop, leading to a decrease in the PLP intensity. The upper limb activity on the amputated side may have also increased with the pain reduction. These results suggest that VRT may be valuable in reducing severe, long-term PLP.https://www.frontiersin.org/articles/10.3389/fnhum.2023.1246865/fullvirtual realityphantom limb painamputationupper limb activityrehabilitationmotor imagery |
| spellingShingle | Manabu Yoshimura Hiroshi Kurumadani Junya Hirata Katsutoshi Senoo Kozo Hanayama Toru Sunagawa Kosuke Uchida Akio Gofuku Kenji Sato Case Report: Virtual reality training for phantom limb pain after amputation Frontiers in Human Neuroscience virtual reality phantom limb pain amputation upper limb activity rehabilitation motor imagery |
| title | Case Report: Virtual reality training for phantom limb pain after amputation |
| title_full | Case Report: Virtual reality training for phantom limb pain after amputation |
| title_fullStr | Case Report: Virtual reality training for phantom limb pain after amputation |
| title_full_unstemmed | Case Report: Virtual reality training for phantom limb pain after amputation |
| title_short | Case Report: Virtual reality training for phantom limb pain after amputation |
| title_sort | case report virtual reality training for phantom limb pain after amputation |
| topic | virtual reality phantom limb pain amputation upper limb activity rehabilitation motor imagery |
| url | https://www.frontiersin.org/articles/10.3389/fnhum.2023.1246865/full |
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