Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston B152TT, Birmingham, United Kingdom. Applied Surgical and Rehabilitation Technology Lab, Department of Trauma Surgery, Orthopedic Surgery and Hand Surgery, University Medical Center Göttingen, Göttingen, Germany. Department of Translational Research and Knowledge Management, Otto Bock HealthCare GmbH, Duderstadt, Germany.
J Neural Eng. 2018 Dec;15(6):066022. doi: 10.1088/1741-2552/aae271. Epub 2018 Sep 19.
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.
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.
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. Multimodal sensory-motor training on phantom-limb movements with visual and tactile feedback is a new method for PLP reduction.
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.
导致幻肢痛（PLP）的原因尚不清楚，这种情况影响了 85%的截肢者，目前可用的治疗方法效果有限。基于感觉反馈的策略可以使控制幻肢的运动指令正常化，为新的有效治疗方法提供了重要目标，因为已经确定幻肢运动控制与运动意图的感觉反馈之间的相关性是 PLP 发展的一种可能机制。
10 名上肢截肢者患有慢性 PLP，接受了为期 16 天的幻肢运动控制强化训练。通过残肢肌肉活动驱动视觉和触觉反馈，旨在减轻 PLP 强度。
在随访时（训练结束后 6 周）获得了 32.1%的 PLP 强度降低（训练结束时立即降低了 21.6%），达到了慢性疼痛减轻的临床效果。使用来自残肢肌肉活动的视觉和触觉反馈对幻肢运动进行多模态感觉运动训练是一种减轻 PLP 的新方法。
研究结果表明，通过一种新的训练方案，可以显著降低幻肢疼痛强度，该方案专注于通过使用来自残肢肌肉活动的视觉和触觉反馈来改善幻肢运动输出，从而移动幻肢。
