Chau Brian, Phelan Ivan, Ta Phillip, Humbert Sarah, Hata Justin, Tran Duc
Dr. Chau, Dr. Ta, Dr. Humbert, Dr. Hata, and Dr. Tran are with the Department of Physical Medicine & Rehabilitation at Loma Linda University Health. Mr. Phelan is with the Research Institute C3RI at Sheffield Hallam University.
Innov Clin Neurosci. 2017 Aug 1;14(7-8):3-7. eCollection 2017 Jul-Aug.
Phantom limb pain is a condition frequently experienced after amputation. One treatment for phantom limb pain is traditional mirror therapy, yet some patients do not respond to this intervention, and immersive virtual reality mirror therapy offers some potential advantages. We report the case of a patient with severe phantom limb pain following an upper limb amputation and successful treatment with therapy in a custom virtual reality environment. An interactive 3-D kitchen environment was developed based on the principles of mirror therapy to allow for control of virtual hands while wearing a motion-tracked, head-mounted virtual reality display. The patient used myoelectric control of a virtual hand as well as motion-tracking control in this setting for five therapy sessions. Pain scale measurements and subjective feedback was elicited at each session. Analysis of the measured pain scales showed statistically significant decreases per session [Visual Analog Scale, Short Form McGill Pain Questionnaire, and Wong-Baker FACES pain scores decreased by 55 percent (p=0.0143), 60 percent (p=0.023), and 90 percent (p=0.0024), respectively]. Significant subjective pain relief persisting between sessions was also reported, as well as marked immersion within the virtual environments. On followup at six weeks, the patient noted continued decrease in phantom limb pain symptoms. Currently available immersive virtual reality technology with myolectric and motion tracking control may represent a possible therapy option for treatment-resistant phantom limb pain.
幻肢痛是截肢后经常出现的一种状况。传统镜像疗法是治疗幻肢痛的一种方法，但有些患者对这种干预措施没有反应，而沉浸式虚拟现实镜像疗法具有一些潜在优势。我们报告了一例上肢截肢后患有严重幻肢痛的患者，其在定制的虚拟现实环境中接受治疗并取得成功的病例。基于镜像疗法的原理开发了一个交互式三维厨房环境，以便在佩戴运动追踪头戴式虚拟现实显示器时控制虚拟手。在这种环境下，患者使用肌电控制虚拟手以及运动追踪控制进行了五次治疗。每次治疗时都进行疼痛量表测量并收集主观反馈。对测量的疼痛量表进行分析显示，每次治疗后疼痛均有统计学意义的显著降低[视觉模拟量表、简化麦吉尔疼痛问卷和面部表情疼痛评分分别降低了55%（p = 0.0143）、60%（p = 0.023）和90%（p = 0.0024）]。还报告了各次治疗之间持续存在的显著主观疼痛缓解，以及在虚拟环境中的高度沉浸感。在六周后的随访中，患者指出幻肢痛症状持续减轻。目前可用的具有肌电和运动追踪控制功能的沉浸式虚拟现实技术可能是治疗难治性幻肢痛的一种可行治疗选择。
