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- Lendaro, Eva, 1989, et al.
(författare)
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Phantom Motor Execution as a strategy to treat Phantom Limb Pain: A case study on a lower limb sufferer.
- 2017
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Ingår i: Phantom Motor Execution as a strategy to treat Phantom Limb Pain: A case study on a lower limb sufferer., 6th International Congress on Neuropathic Pain (NeuPSIG), June 15-18, 2017, Gothenburg, Sweden..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background and Aims:Phantom Motor Execution (PME) facilitated by Myoelectric Pattern Recognition (MPR) and Virtual Reality (VR) poses itself as an effective treatment for Phantom Limb Pain (PLP). Notably, a recent clinical control trial using the methodology on a population of 14 upper limb amputees with intractable PLP showed significant improvements (Ortiz-Catalan, 2016). The present study aims at assessing whether PME facilitated by MPR and VR can reduce PLP in lower limb.Methods:A 70-years-old male with trans-femoral amputation was treated for a total of 24 PME treatment sessions. Pain was assessed in terms of Weighted Pain Distribution (WDP) (Ortiz-Catalan, 2014) and Short Form of McGill Pain Questionnaire (SF-MPQ). The treatment consisted in using myoelectric signals produced by stump muscles during phantom motions in order to control a VR limb.Results:SF-MPQ showed a significant reduction (>%50) in the number of word chosen and in the Pain Rating Index (Figure 1). WDP (Figure 2) shows reduction of time spent in pain. Improvement of sleep (from 2h to 7h/night) was also reported.Conclusions:Although the results are limited to one subject, this study indicates that PME could potentially reduce PLP also in the lower limb.
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| 2. |
- Lendaro, Eva, 1989, et al.
(författare)
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Phantom motor execution in the lower limb aided by myoelectric pattern recognition and virtual reality: A case study on a chronic phantom limb pain sufferer.
- 2017
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Ingår i: XVI World Congress of the International Society for Prosthetics and Orthotics (ISPO), Cape Town 8-11 May 2017. ; , s. 195-
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- BACKGROUNDPhantom Motor Execution (PME) facilitated byMyoelectric Pattern Recognition (MPR) and VirtualReality (VR)1 poses itself as an effective treatment forPhantom Limb Pain (PLP). Notably, a recent clinicaltrial using the methodology on a population of 14 upperlimb amputees with intractable chronic PLP showedstatistically significant improvements (approx. 50%reduction) in all the metrics used to measure PLP2.AIMThis study aimed to assess, for the first time, the efficacyof PME facilitated by MPR and VR in reducing PLP inthe lower limb.METHODA 70-years-old male with traumatic trans-femoralamputation since 35 years on the right side was treatedtwice a week, for a total of 23 sessions. Each sessionconsisted of pre-treatment pain assessment, electrodeplacement, PME treatment (2.0 h) and post-treatmentpain evaluation. Pain was assessed in terms of WeightedPain Distribution (WPD), Numeric Rating Scale (NRS),Pain Perception Frequency (PPF) and Short Form ofMcGill Pain Questionnaire (SF-MPQ)3.Moreover, effects on quality of life, disability andparticipation levels as well as intrusion of PLP inactivities of the daily living and sleep were monitored.The PME treatment consisted in using myoelectricsignals produced in stump muscles during phantommotions in order to control a VR limb. This was madepossible thanks to the MPR system BioPatRec4.RESULTSFigure 1 shows the visual representation of WDP as itis registered at the beginning of each session: a general,however not complete, reduction of pain can be noticed.The highest levels of PLP (4 and 5), usually present inthe evening and at night disappeared over time. As aconsequence, length and quality of sleep increase from2h/night with interruptions to 7h/night undisturbed.SF-MPQ showed a significant reduction (>50%) in thenumber of chosen pain descriptors as well as in thePain Rating Index. Quality of life improved drastically:the patient reported less tiredness, improved mood andregained ability to drive for long distance (> 200 km at atime, not possible before). Moderate levels of PLP (1-3in Figure 1) are still present, accounting for unchangedscore in NRS and PPF.
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| 3. |
- Lendaro, Eva, 1989, et al.
(författare)
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Real-time classification of non-weight bearing lower-limb movements using EMG to facilitate phantom motor execution: Engineering and case study application on phantom limb pain
- 2017
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Ingår i: Frontiers in Neurology. - : Frontiers Media SA. - 1664-2295. ; 8:SEP, s. Article number 470-
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Tidskriftsartikel (refereegranskat)abstract
- Phantom motor execution (PME), facilitated by myoelectric pattern recognition (MPR) and virtual reality (VR), is positioned to be a viable option to treat phantom limb pain (PLP). A recent clinical trial using PME on upper-limb amputees with chronic intractable PLP yielded promising results. However, further work in the area of signal acquisition is needed if such technology is to be used on subjects with lower-limb amputation. We propose two alternative electrode configurations to conventional, bipolar, targeted recordings for acquiring surface electromyography. We evaluated their performance in a real-time MPR task for non-weight-bearing, lower-limb movements. We found that monopolar recordings using a circumferential electrode of conductive fabric, performed similarly to classical bipolar recordings, but were easier to use in a clinical setting. In addition, we present the first case study of a lower-limb amputee with chronic, intractable PLP treated with PME. The patient's Pain Rating Index dropped by 22 points (from 32 to 10, 68%) after 23 PME sessions. These results represent a methodological advancement and a positive proof-of-concept of PME in lower limbs. Further work remains to be conducted for a high-evidence level clinical validation of PME as a treatment of PLP in lower-limb amputees.
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