Direct Visual Observation Therapy Relieves Phantom-Limb Pain

BETHESDA, MD – With as many as one-third of unilateral=limb amputees suffering regularly from phantom limb pain, military medicine has been in search of an inexpensive and effective treatment.

A study published recently in the Annals of Clinical and Translational Neurology suggests they might be on the way to a solution.1

Background in the study, led by researchers from Walter Reed National Military Medical Center, noted that mirror therapy has been demonstrated to reduce phantom limb pain (PLP) experienced by unilateral limb amputees. Research suggests that the visual feedback of observing a limb moving in the mirror is critical for therapeutic efficacy, they point out.

With mirror therapy not an option for bilateral lower limb amputees, however, the purpose of the study was to determine if direct observation of another person’s limbs could be used to relieve PLP.

To test the theory, researchers randomly assigned 20 bilateral lower limb amputees with PLP to either visual observation or mental visualization treatment. Treatment consisted of seven discrete movements which were either mimicked by the amputee’s phantom limbs moving while visually observing the experimenter’s limbs moving or by closing the eyes while visualizing and attempting the movements with their phantom limbs.

Participants performed movements for 20 minutes daily for one month. Response to therapy was measured using a 100-mm visual analog scale (VAS) and the McGill Short-Form Pain Questionnaire (SF-MPQ).

Results indicated that direct visual observation significantly reduced PLP in both legs, while amputees assigned to the mental visualization condition did not show a significant reduction in PLP.

“Direct visual observation therapy is an inexpensive and effective treatment for PLP that is accessible to bilateral lower limb amputees,” the authors concluded.

  1. Tung ML, Murphy IC, Griffin SC, Alphonso AL, Hussey-Anderson L, Hughes KE,

Weeks SR, Merritt V, Yetto JM, Pasquina PF, Tsao JW. Observation of limb

movements reduces phantom limb pain in bilateral amputees. Ann Clin Transl

Neurol. 2014 Sep;1(9):633-8. doi: 10.1002/acn3.89. Epub 2014 Sep 30. PubMed PMID:

25493277; PubMed Central PMCID: PMC4241790.

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