Can immersive virtual reality reduce phantom limb pain?

This paper describes the design and implementation of a case-study based investigation using immersive virtual reality as a treatment for phantom limb pain. The authors' work builds upon prior research which has found the use of a mirror box (where the amputee sees a mirror image of their remaining anatomical limb in the phenomenal space of their amputated limb) can reduce phantom limb pain and voluntary movement to paralyzed phantom limbs for some amputees. The present project involves the transposition of movements made by amputees' anatomical limb into movements of a virtual limb which is presented in the phenomenal space of their phantom limb. The three case studies presented here provide qualitative data which provide tentative support for the use of this system for phantom pain relief. The authors suggest the need for further research using control trials

Virtual solutions to phantom problems: Using immersive virtual reality to treat phantom limb pain

Phantom limb pain (PLP) is a common consequence of amputation, and many persons with amputations experience vivid sensations of pain in the absent body part. PLP can persist for many years post-amputation and is very difficult to treat, since its aetiology is hard to determine. However, converging lines of evidence demonstrate that when visual feedback is manipulated appropriately to represent movement of an amputee’s absent limb, it can evoke kinesthetic sensations of movement in that limb and decrease PLP. Most notably, the mirror box – where a mirror is placed vertically in front of the person with an amputation – is used in such a way as to reflect the image of an intact limb onto the phenomenal space of the absent or phantom limb. When amputees orient towards this mirror image kinaesthetic sensations can be evoked in the muscles and joints of their phantom limb, and PLP can be decreased. Some researchers have highlighted limitations in the flexibility of the mirror box in providing a fully robust illusion of an absent limb as intact. Recently, three research groups have developed virtual reality systems informed by mirror-box work for the treatment of PLP. Although similar in intent and design, these systems have subtle differences. This chapter will outline these systems along with empirical findings, with a particular emphasis on the authors’ own virtual reality system

Investigating the efficacy of a virtual mirror box in treating phantom limb pain in a sample of chronic sufferers.

This paper describes a pilot study to evaluate the efficacy of using immersive virtual reality (IVR) to treat phantom limb pain. This work builds upon prior research using a mirror box (in which the amputee sees a mirror image of their remaining anatomical limb in the phenomenal space of their amputated limb) to induce vivid sensations of movement originating from the muscles and joints of their phantom limb and to relieve pain. The IVR system likewise transposes movements of amputees’ anatomical limbs into movements of a virtual limb. Participants used the IVR system on a weekly basis over a 2.5 month period. Because of the small sample size (n = 5), the primary focus here is on a qualitative analysis of interview data with each participant throughout the study. We argue that the findings of this work make a case for proof of principle for this approach for phantom pain treatment