SAN DIEGO—Virtual reality appears to be a feasible way to treat phantom limb pain at the VA, according to a small new study.

The report in Pain Medicine sought to describe the development of a virtual reality treatment for phantom limb pain and phantom sensations while providing feasibility data from testing the treatment in a veteran population.1

A San Diego Healthcare System-led researchers had 14 participants complete a baseline visit evaluating their amputation, PLP, and phantom sensations. The study team then provided VR treatment modeled after mirror therapy for PLP. Patients navigated in a VR environment with a bicycle pedaler and motion sensor to pair their cadence to a VR avatar. In a hypothesized he VR avatar enabled visualization of the participant’s intact phantom limb in motion.

Researchers measured participants pre- and post-treatment to evaluate changes in PLP, phantom sensations, and rate helpfulness, realism, immersion, adverse experiences and treatment satisfaction.

Phantom limb pain was reported pre-VR treatment in eight of 14 participants (57.1%), while nearly all—13 of 14—reported one or more unpleasant phantom sensations. 

Results indicated that, After treatment, 28.6% (4/14) continued to report PLP symptoms (t[13] = 2.7, P = 0.02, d = 0.53) and 28.6% (4/14) reported phantom sensations (t[13] = 4.4, P = 0.001, d = 1.7). Ratings of helpfulness, realism, immersion and satisfaction were uniformly high to very high and no adverse experiences were reported.

In fact, four participants completed multiple VR treatments, showing stable improvements in PLP intensity and phantom sensations and high user ratings, according to researchers.

“This feasibility study of a novel VR intervention for PLP was practical and was associated with significant reductions in PLP intensity and phantom sensations,” the study authors concluded. “Our findings support continued research in VR-based treatments in PLP, with a need for direct comparisons between VR and more established PLP treatments.”

1. Rutledge T, Velez D, Depp C, McQuaid JR, Wong G, Jones RCW, Atkinson JH, Giap B, Quan A, Giap H. A Virtual Reality Intervention for the Treatment of Phantom Limb Pain: Development and Feasibility Results. Pain Med. 2019 Jun 5. pii:pnz121. doi: 10.1093/pm/pnz121. [Epub ahead of print] PubMed PMID: 31165893.