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Ann Clin Transl Neurol. 2014 Sep;1(9):633-8. doi: 10.1002/acn3.89. Epub 2014 Sep 30.

Observation of limb movements reduces phantom limb pain in bilateral amputees.

Annals of clinical and translational neurology

Monica L Tung, Ian C Murphy, Sarah C Griffin, Aimee L Alphonso, Lindsey Hussey-Anderson, Katie E Hughes, Sharon R Weeks, Victoria Merritt, Joseph M Yetto, Paul F Pasquina, Jack W Tsao

Affiliations

  1. Walter Reed National Military Medical Center 8900 Wisconsin Avenue, Bethesda, Maryland, 20889.
  2. Walter Reed National Military Medical Center 8900 Wisconsin Avenue, Bethesda, Maryland, 20889 ; Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences 4301 Jones Bridge Road, Rm A1036, Bethesda, Maryland 20814.
  3. US Navy Bureau of Medicine and Surgery 7700 Arlington Blvd., Falls Church, Virginia, 22042 ; Department of Neurology, Uniformed Services University of the Health Sciences 4301 Jones Bridge Road, Rm A1036, Bethesda, Maryland, 20814.

PMID: 25493277 PMCID: PMC4241790 DOI: 10.1002/acn3.89

Abstract

BACKGROUND: Mirror therapy has been demonstrated to reduce phantom limb pain (PLP) experienced by unilateral limb amputees. Research suggests that the visual feedback of observing a limb moving in the mirror is critical for therapeutic efficacy.

OBJECTIVE: Since mirror therapy is not an option for bilateral lower limb amputees, the purpose of this study was to determine if direct observation of another person's limbs could be used to relieve PLP.

METHODS: We randomly assigned 20 bilateral lower limb amputees with PLP to visual observation (n = 11) or mental visualization (n = 9) treatment. Treatment consisted of seven discrete movements which were mimicked by the amputee's phantom limbs moving while visually observing the experimenter's limbs moving, or closing the eyes while visualizing and attempting the movements with their phantom limbs, respectively. Participants performed movements for 20 min daily for 1 month. Response to therapy was measured using a 100-mm visual analog scale (VAS) and the McGill Short-Form Pain Questionnaire (SF-MPQ).

RESULTS: Direct visual observation significantly reduced PLP in both legs (P < 0.05). Amputees assigned to the mental visualization condition did not show a significant reduction in PLP.

INTERPRETATION: Direct visual observation therapy is an inexpensive and effective treatment for PLP that is accessible to bilateral lower limb amputees.

References

  1. Nat Rev Neurosci. 2006 Nov;7(11):873-81 - PubMed
  2. Neurocase. 2010 Dec;16(6):461-5 - PubMed
  3. N Engl J Med. 2007 Nov 22;357(21):2206-7 - PubMed
  4. Med Hypotheses. 2009 Oct;73(4):555-8 - PubMed
  5. Neuroimage. 2003 Nov;20 Suppl 1:S107-11 - PubMed
  6. Injury. 2011 Dec;42(12):1474-9 - PubMed
  7. Neurosurgery. 2003 Dec;53(6):1342-52; discussion 1352-3 - PubMed
  8. Arch Neurol. 2009 Oct;66(10):1281-4 - PubMed
  9. Pain Med. 2014 Feb;15(2):292-305 - PubMed
  10. Int J Rehabil Res. 2011 Mar;34(1):1-13 - PubMed
  11. Brain. 2009 Jul;132(Pt 7):1693-710 - PubMed
  12. Neuroscientist. 2008 Apr;14(2):195-202 - PubMed
  13. Neuropsychologia. 2010 Oct;48(12):3675-8 - PubMed
  14. Brain. 1998 Sep;121 ( Pt 9):1603-30 - PubMed
  15. Clin Neurophysiol. 2007 Nov;118(11):2468-78 - PubMed
  16. Neuroreport. 1992 Jul;3(7):583-6 - PubMed
  17. Nat Commun. 2013;4:1570 - PubMed
  18. J Rehabil Res Dev. 2007;44(4):491-501 - PubMed
  19. Neurology. 2006 Dec 26;67(12):2129-34 - PubMed
  20. J Cogn Neurosci. 1999 Sep;11(5):491-501 - PubMed
  21. Pain. 1987 Aug;30(2):191-7 - PubMed
  22. Nature. 1995 Jun 8;375(6531):482-4 - PubMed
  23. Annu Rev Neurosci. 2004;27:169-92 - PubMed
  24. Proc Biol Sci. 1996 Apr 22;263(1369):377-86 - PubMed
  25. Neurosci Lett. 2001 Apr 13;302(1):13-6 - PubMed
  26. Pain Physician. 2004 Jul;7(3):365-75 - PubMed
  27. Arch Phys Med Rehabil. 2008 Mar;89(3):422-9 - PubMed
  28. Brain. 2008 Aug;131(Pt 8):2181-91 - PubMed

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