Clinical Trial of the Virtual Integration Environment to Treat Phantom Limb Pain With Upper Extremity Amputation
Background: Phantom limb pain (PLP) is commonly seen following upper extremity (UE) amputation. Use of both mirror therapy, which utilizes limb reflection in a mirror, and virtual reality therapy, which utilizes computer limb simulation, has been used to relieve PLP. We explored whether the Virtual...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2018-09-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2018.00770/full |
| _version_ | 1818543290439434240 |
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| author | Briana N. Perry Robert S. Armiger Mikias Wolde Kayla A. McFarland Aimee L. Alphonso Brett T. Monson Paul F. Pasquina Paul F. Pasquina Jack W. Tsao Jack W. Tsao Jack W. Tsao |
| author_facet | Briana N. Perry Robert S. Armiger Mikias Wolde Kayla A. McFarland Aimee L. Alphonso Brett T. Monson Paul F. Pasquina Paul F. Pasquina Jack W. Tsao Jack W. Tsao Jack W. Tsao |
| author_sort | Briana N. Perry |
| collection | DOAJ |
| description | Background: Phantom limb pain (PLP) is commonly seen following upper extremity (UE) amputation. Use of both mirror therapy, which utilizes limb reflection in a mirror, and virtual reality therapy, which utilizes computer limb simulation, has been used to relieve PLP. We explored whether the Virtual Integration Environment (VIE), a virtual reality UE simulator, could be used as a therapy device to effectively treat PLP in individuals with UE amputation.Methods: Participants with UE amputation and PLP were recruited at Walter Reed National Military Medical Center (WRNMMC) and instructed to follow the limb movements of a virtual avatar within the VIE system across a series of study sessions. At the end of each session, participants drove virtual avatar limb movements during a period of “free-play” utilizing surface electromyography recordings collected from their residual limbs. PLP and phantom limb sensations were assessed at baseline and following each session using the Visual Analog Scale (VAS) and Short Form McGill Pain Questionnaire (SF-MPQ), respectively. In addition, both measures were used to assess residual limb pain (RLP) at baseline and at each study session. In total, 14 male, active duty military personnel were recruited for the study.Results: Of the 14 individuals recruited to the study, nine reported PLP at the time of screening. Eight of these individuals completed the study, while one withdrew after three sessions and thus is not included in the final analysis. Five of these eight individuals noted RLP at baseline. Participants completed an average of 18, 30-min sessions with the VIE leading to a significant reduction in PLP in seven of the eight (88%) affected limbs and a reduction in RLP in four of the five (80%) affected limbs. The same user reported an increase in PLP and RLP across sessions. All participants who denied RLP at baseline (n = 3) continued to deny RLP at each study session.Conclusions: Success with the VIE system confirms its application as a non-invasive and low-cost therapy option for PLP and phantom limb symptoms for individuals with upper limb loss. |
| first_indexed | 2024-12-11T22:33:26Z |
| format | Article |
| id | doaj.art-b69cb1819bd74aacbcf58f99e44b4da8 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-11T22:33:26Z |
| publishDate | 2018-09-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj.art-b69cb1819bd74aacbcf58f99e44b4da82022-12-22T00:48:03ZengFrontiers Media S.A.Frontiers in Neurology1664-22952018-09-01910.3389/fneur.2018.00770334103Clinical Trial of the Virtual Integration Environment to Treat Phantom Limb Pain With Upper Extremity AmputationBriana N. Perry0Robert S. Armiger1Mikias Wolde2Kayla A. McFarland3Aimee L. Alphonso4Brett T. Monson5Paul F. Pasquina6Paul F. Pasquina7Jack W. Tsao8Jack W. Tsao9Jack W. Tsao10Walter Reed National Military Medical Center, Bethesda, MD, United StatesApplied Physics Laboratory, Johns Hopkins University, Laurel, MD, United StatesWalter Reed National Military Medical Center, Bethesda, MD, United StatesWalter Reed National Military Medical Center, Bethesda, MD, United StatesWalter Reed National Military Medical Center, Bethesda, MD, United StatesWalter Reed National Military Medical Center, Bethesda, MD, United StatesWalter Reed National Military Medical Center, Bethesda, MD, United StatesUniformed Services University of the Health Sciences, Bethesda, MD, United StatesWalter Reed National Military Medical Center, Bethesda, MD, United StatesUniformed Services University of the Health Sciences, Bethesda, MD, United StatesUniversity of Tennessee Health Science Center, Memphis, TN, United StatesBackground: Phantom limb pain (PLP) is commonly seen following upper extremity (UE) amputation. Use of both mirror therapy, which utilizes limb reflection in a mirror, and virtual reality therapy, which utilizes computer limb simulation, has been used to relieve PLP. We explored whether the Virtual Integration Environment (VIE), a virtual reality UE simulator, could be used as a therapy device to effectively treat PLP in individuals with UE amputation.Methods: Participants with UE amputation and PLP were recruited at Walter Reed National Military Medical Center (WRNMMC) and instructed to follow the limb movements of a virtual avatar within the VIE system across a series of study sessions. At the end of each session, participants drove virtual avatar limb movements during a period of “free-play” utilizing surface electromyography recordings collected from their residual limbs. PLP and phantom limb sensations were assessed at baseline and following each session using the Visual Analog Scale (VAS) and Short Form McGill Pain Questionnaire (SF-MPQ), respectively. In addition, both measures were used to assess residual limb pain (RLP) at baseline and at each study session. In total, 14 male, active duty military personnel were recruited for the study.Results: Of the 14 individuals recruited to the study, nine reported PLP at the time of screening. Eight of these individuals completed the study, while one withdrew after three sessions and thus is not included in the final analysis. Five of these eight individuals noted RLP at baseline. Participants completed an average of 18, 30-min sessions with the VIE leading to a significant reduction in PLP in seven of the eight (88%) affected limbs and a reduction in RLP in four of the five (80%) affected limbs. The same user reported an increase in PLP and RLP across sessions. All participants who denied RLP at baseline (n = 3) continued to deny RLP at each study session.Conclusions: Success with the VIE system confirms its application as a non-invasive and low-cost therapy option for PLP and phantom limb symptoms for individuals with upper limb loss.https://www.frontiersin.org/article/10.3389/fneur.2018.00770/fullvirtual reality therapyupper extremity amputationupper limb amputationphantom limb painvirtual integration environmentmirror therapy |
| spellingShingle | Briana N. Perry Robert S. Armiger Mikias Wolde Kayla A. McFarland Aimee L. Alphonso Brett T. Monson Paul F. Pasquina Paul F. Pasquina Jack W. Tsao Jack W. Tsao Jack W. Tsao Clinical Trial of the Virtual Integration Environment to Treat Phantom Limb Pain With Upper Extremity Amputation Frontiers in Neurology virtual reality therapy upper extremity amputation upper limb amputation phantom limb pain virtual integration environment mirror therapy |
| title | Clinical Trial of the Virtual Integration Environment to Treat Phantom Limb Pain With Upper Extremity Amputation |
| title_full | Clinical Trial of the Virtual Integration Environment to Treat Phantom Limb Pain With Upper Extremity Amputation |
| title_fullStr | Clinical Trial of the Virtual Integration Environment to Treat Phantom Limb Pain With Upper Extremity Amputation |
| title_full_unstemmed | Clinical Trial of the Virtual Integration Environment to Treat Phantom Limb Pain With Upper Extremity Amputation |
| title_short | Clinical Trial of the Virtual Integration Environment to Treat Phantom Limb Pain With Upper Extremity Amputation |
| title_sort | clinical trial of the virtual integration environment to treat phantom limb pain with upper extremity amputation |
| topic | virtual reality therapy upper extremity amputation upper limb amputation phantom limb pain virtual integration environment mirror therapy |
| url | https://www.frontiersin.org/article/10.3389/fneur.2018.00770/full |
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