Kawasaki University of Medical Welfare, Okayama, Japan.
Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Prosthet Orthot Int. 2022 Aug 1;46(4):320-326. doi: 10.1097/PXR.0000000000000122. Epub 2022 Mar 25.
Phantom limb pain (PLP) is a frequent painful sensation in amputees, and motor imagery (MI) is a useful approach for the treatment of this type of pain. However, it is not clear regarding the best MI modality for PLP.
The purpose of this study was to investigate the relationship between the PLP and MI modality in upper limb amputees.
Observational study.
Eleven patients who underwent unilateral upper limb amputation participated in this study. The MI modality (kinesthetic and visual) and PLP intensity were evaluated using the Kinesthetic and Visual Imagery Questionnaire (KVIQ)-20 and a visual analog scale. MI ability was also assessed during the hand mental rotation task. We examined the correlation between MI modalities, ability, and pain intensity.
The total KVIQ kinesthetic score was negatively correlated with pain intensity (r = -0.71, P < 0.01): the more vivid the kinesthetic imagery, the weaker the pain. In particular, the reduction in pain intensity was associated with strong kinesthetic imagery of opposing movements of the deficient thumb (r = -0.81, P < 0.01). The KVIQ visual score and MI ability were not associated with pain intensity.
Our data showed that the reduction of PLP could be associated with the kinesthetic modality of MI but not with visual modality or MI ability. In other words, it was suggested that the more vivid the sensation of moving muscles and joints in the defect area, the lower the PLP intensity. To reduce PLP, clinicians may prefer interventions using the kinesthetic modality.
幻肢痛（PLP）是截肢患者常见的疼痛感觉，运动意象（MI）是治疗这种疼痛的一种有效方法。然而，对于 PLP 最佳的 MI 方式尚不清楚。
本研究旨在探讨上肢截肢患者 PLP 与 MI 方式之间的关系。
观察性研究。
11 名接受单侧上肢截肢的患者参与了本研究。使用运动意象问卷（KVIQ）-20 和视觉模拟评分评估 MI 方式（动觉和视觉）和 PLP 强度。在手心理旋转任务中还评估了 MI 能力。我们检查了 MI 方式、能力和疼痛强度之间的相关性。
总 KVIQ 动觉评分与疼痛强度呈负相关（r = -0.71，P < 0.01）：动觉意象越生动，疼痛越弱。特别是，疼痛强度的降低与对缺陷拇指的对抗运动的强烈动觉意象有关（r = -0.81，P < 0.01）。KVIQ 视觉评分和 MI 能力与疼痛强度无关。
我们的数据表明，PLP 的减少可能与 MI 的动觉方式有关，而与视觉方式或 MI 能力无关。换句话说，建议在缺陷区域移动肌肉和关节的感觉越生动，PLP 强度越低。为了降低 PLP，临床医生可能更喜欢使用动觉方式的干预措施。
