Relieving phantom limb pain with multimodal sensory-motor training

Research output: Contribution to journalArticle

Authors

  • Meike Annika Schweisfurth
  • Nan Ge
  • Janne Mathias Hahne
  • Kim Gödecke
  • Frank Petzke
  • Mathias Siebertz
  • Peter Dechent
  • Thomas Weiss
  • Herta Flor
  • Bernhard Graimann
  • Oskar Aszmann
  • Dario Farina

External organisations

  • Centre of Precision Rehabilitation for Spinal Pain, University of Birmingham School of Sport Exercise and Rehabilitation Sciences, Birmingham, B15 2TT, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND.
  • Faculty of Life Sciences, Hochschule für Angewandte Wissenschaften, Hamburg, Hamburg, GERMANY.
  • Neurorehabilitation Systems Research Group, Department of Trauma Surgery, Orthopedic Surgery and Hand Surger, University Medical Center Göttingen, Göttingen, GERMANY.
  • Centre of Precision Rehabilitation for Spinal Pain, University of Birmingham School of Sport Exercise and Rehabilitation Sciences, Birmingham, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND.
  • Trauma Surgery, Orthopedic Surgery and Hand Surgery, Universitätsmedizin Göttingen, Göttingen, GERMANY.
  • Pain Clinic, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen, Göttingen, Germany; Department of Neurorehabilitation Engineering, Bernstein Focus Neurotechnology (BFNT) Göttingen, Bernstein Center for Computational Neuroscience, University Medical Center Göttingen, Georg-August University, Göttingen, Germany. Electronic address: deborah.falla@bccn.uni-goettingen.de.
  • MR research in neurology and psychiatry, Cognitive Neurology, University Medical Center Göttingen, Georg-August University, Göttingen, Göttingen, GERMANY.
  • Department of Biological and Clinical Psychology, Institute of Psychology, Friedrich Schiller University, Jena, GERMANY.
  • Zentralinstitut fur Seelische Gesundheit, Mannheim, 68072, GERMANY.
  • Department of Translational Research and Knowledge Management, Otto Bock HealthCare GmbH, Max-Näder-Straße 15, 37115, Duderstadt, Germany.
  • Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, AUSTRIA.
  • Imperial College London

Abstract

Background: The causes for the disabling condition of phantom limb pain (PLP), affecting 85% of amputees, are so far unknown, with few effective treatments available. Sensory feedback based strategies to normalize the motor commands to control the phantom limb offer important targets for new effective treatments as the correlation between phantom limb motor control and sensory feedback from the motor intention has been identified as a possible mechanism for PLP development.

Methods: Ten upper-limb amputees, suffering from chronic PLP, underwent 16 days of intensive training on phantom-limb movement control. Visual and tactile feedback, driven by muscular activity at the stump, was provided with the aim of reducing PLP intensity.

Results: A 32.1% reduction of PLP intensity was obtained at the follow-up (6 weeks after the end of the training, with an initial 21.6% reduction immediately at the end of the training) reaching clinical effectiveness for chronic pain reduction.

Conclusion: Multimodal sensory-motor training on phantom-limb movements with visual and tactile feedback is a new method for PLP reduction.

Significance: The study results revealed a substantial reduction in phantom limb pain intensity, obtained with a new training protocol focused on improving phantom limb motor output using visual and tactile feedback from the stump muscular activity executed to move the phantom limb.

Details

Original languageEnglish
Article number066022
JournalJournal of Neural Engineering
Volume15
Early online date19 Sep 2018
Publication statusPublished - 16 Oct 2018

Keywords

  • Motor Training, Phantom Limb Pain, Sensory Feedback