Training With Virtual Visual Feedback to Alleviate Phantom Limb Pain
Training With Virtual Visual Feedback to Alleviate Phantom Limb Pain
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DOI：
10.1177/1545968308328717
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发表时间：
2009-07-01
影响因子：
4.2
通讯作者：
Sirigu, Angela
中科院分区：
文献类型：
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作者：
Mercier, Catherine;Sirigu, Angela
背景通过视觉虚拟反馈进行幻肢运动或镜像疗法是一种有前途的缓解幻肢疼痛的治疗途径。然而，这种方法的有效性似乎因患者而异。Objective.评估个体对视觉虚拟反馈训练的反应，并探讨影响这种方法反应的因素。方法. 8名患有创伤性上肢截肢或臂丛撕脱引起的幻肢痛（PLP）的男性参与者参加了这项单一病例多基线研究。训练每周进行2次，持续8周，其中呈现进行不同运动的缺失肢体的虚拟图像，并要求参与者用他的幻肢跟随运动。结果根据视觉模拟量表（VAS），患者报告背景疼痛平均减少38%，8例患者中有5例报告减少超过30%。5名参与者中有4名在干预后4周保持疼痛减轻。没有显着的关系之间的长期疼痛缓解和持续时间的deafferentation或与即时疼痛缓解暴露于反馈。结论.这些结果支持使用虚拟反馈训练来减轻幻肢疼痛。我们的观察结果表明，参与者之间的治疗效果的差异可能更多地与虚拟视觉反馈的敏感性的差异，而不是与病变相关的因素，如持续时间的传入阻滞。
Background. Performing phantom movements with visual virtual feedback, or mirror therapy, is a promising treatment avenue to alleviate phantom limb pain. However the effectiveness of this approach appears to vary from one patient to another. Objective. To assess the individual response to training with visual virtual feedback and to explore factors influencing the response to that approach. Methods. Eight male participants with phantom limb pain (PLP) resulting from either a traumatic upper limb amputation or a brachial plexus avulsion participated in this single case multiple baseline study. Training was performed 2 times per week for 8 weeks where a virtual image of a missing limb performing different movements was presented and the participant was asked to follow the movements with his phantom limb. Results. Patients reported an average 38% decrease in background pain on a visual analog scale (VAS), with 5 patients out of 8 reporting a reduction greater than 30%. This decrease in pain was maintained at 4 weeks postintervention in 4 of the 5 participants. No significant relationship was found between the long-term pain relief and the duration of the deafferentation or with the immediate pain relief during exposure to the feedback. Conclusions. These results support the use of training with virtual feedback to alleviate phantom limb pain. Our observations suggest that between-participant differences in the effectiveness of the treatment might be related more to a difference in the susceptibility to the virtual visual feedback, than to factors related to the lesion, such as the duration of the deafferentation.