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.

• 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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Sjukgymnastik (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Physiotherapy (hsv//eng)

TEKNIK OCH TEKNOLOGIER  -- Medicinteknik (hsv//swe)

ENGINEERING AND TECHNOLOGY  -- Medical Engineering (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Arbetsmedicin och miljömedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Occupational Health and Environmental Health (hsv//eng)

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