Journal
PAIN MEDICINE
Volume 20, Issue 5, Pages 1038-1046Publisher
OXFORD UNIV PRESS
DOI: 10.1093/pm/pny269
Keywords
Phantom Limb Pain; Virtual Reality; Neurorehabilitation; Pain Characteristics; Factor Analysis
Categories
Funding
- JSPS KAKENHI [17K13080]
- Grants-in-Aid for Scientific Research [17K13080] Funding Source: KAKEN
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Objectives. Neurorehabilitation techniques using virtual reality (VR) systems have recently become widespread as a rehabilitation method for restoring phantom limb movement and alleviating phantom limb pain (PLP). However, analgesic effects have varied between studies, possibly because of differences in the characteristics of PLP between patients (e.g., cramping, burning, shooting). We aimed to reveal the relationship between VR effects and PLP characteristics using an exploratory factor analysis. Methods. PLP characteristics of 19 patients were measured using the Short-Form McGill Pain Questionnaire (SF-MPQ), and all PLP patients performed the VR rehabilitation protocol for 20 minutes. During VR rehabilitation, mirror-reversed computer graphic images of an intact arm (the virtual phantom limb) were presented to patients via a head-mounted display, inducing the perception of voluntary execution of movements of their phantom limb when intending bimanual movements. Results. VR rehabilitation significantly restored movement representation (P < 0.0001) quantified using the bimanual coupling effect and significantly alleviated PLP intensity (P < 0.0001). The factor analysis revealed that PLP characteristics could be divided into two factors: somatosensory-related pain characteristics and kinesthesia-related pain characteristics. PLP alleviation via VR rehabilitation was significantly correlated with kinesthesia-related pain characteristics (r= 0.47, P= 0.02) but not somatosensory-related pain characteristics (r=0.22, P= 0.17). Conclusions. The current findings indicate that VR rehabilitation may be particularly effective for PLP associated with distorted phantom limb movement and body representations (e.g., clamping, gnawing), compared with typical neuropathic sensations (e.g., shooting, burning, dysesthesia).
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