Phantom Limb Pain Clinical Trial
Official title:
Phantom Limb Pain: Efficacy of Non-invasive Sensory Feedback Through the Prosthesis
Amputation of a limb may result from trauma or surgical intervention. The amputation
traumatically alters the body image, but often leaves sensations that refer to the missing
body part. In 50-80% amputees, neuropathic pain develops, also called phantom limb pain
(PLP). Both peripheral and central nervous system factors have been implicated as
determinants of PLP. Also, PLP may be triggered by physical (changes in the weather) and
psychological factors (emotional stress). Recent evidence suggests that PLP may be
intricately related to neuroplastic changes in the cortex, and that these changes may
modulated by providing sensory input to the stump or amputation zone.
A non-invasive clinical trial will test the effectiveness of non-invasive pressure sensory
feedback build into a hand prosthesis to alleviate phantom limb pain.
During the pre-screen phase the investigators will assess whether the patient experiences
referred phantom limb sensations or pain. In the case that the patient does experience
referred sensations on the stump the investigators will map the areas where the sensation
occurs on the stump and utilize this for placement of the surface actuators. In the opposite
case, actuators will instead be placed in a matrix structure at the residual limb.
As a first step towards applying mechanical stimulation, the sensation thresholds (the level
of stimulation where the subject first reports a sensation) have to be determined. The
outcome of this procedure is a minimum of stimulation amplitude that can be applied for each
stimulation site.
A first choice would be to use the referred map to place actuators. However, amputees have
different phantom maps and also the number of areas varies.
A therapy will be defined based on the use of sensory feedback system integrated with the
amputees hand prosthesis. The subject should use the hand prosthesis, with sensory feedback,
for a duration of minimum 2 h per day during a 4 week period.
Preferably, the system should be used actively in normal daily activities.
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