Immersive VR in Phantom Limb Pain Therapy of Amputee Patients Due to Critical Limb Ischemia

Abstract

Introduction : Phantom limb pain (PLP) occurs in approximately 75% of patients who undergo limb amputation. In identifying the etiopathogenic mechanisms, multidisciplinary approaches are increasingly important in explaining the causality based on neurological and psychological factors. PLP has many negative effects on the amputee's physical and mental integrity, which is why a variety of treatments have been conceived, whose effectiveness is rather limited. Objective: The purpose of this study is to evaluate the effectiveness of an immersive virtual reality (IVR) intervention program using the mirror therapy principles in decreasing PLP. Method : Twenty participants suffering from PLP were randomly assigned to one of the two intervention groups: IVR and kinesiotherapy, respectively. Pre- and post-intervention measurements were performed both on pain level and on several psychological variables: depression and anxiety symptoms, pain catastrophizing, quality of life, body representation and coping strategies. Results : Preliminary data show a significant pain relief in patients in the IVR group compared to those in the kinesiotherapy group. Besides, significant improvement was found in the case of the patients in the IVR group, in terms of life quality improvement, reducing irrational pain catastrophizing-related thoughts and positive coping strategies (positive refocusing and reappraisal). There were no differences identified between the two groups in terms of anxiety and depression symptoms. Despite expectations, patients in the IVR group experienced a significant increase in one negative coping strategy: rumination. Conclusions : The results obtained are advocating the use of IVI intervention as a method phantom limb pain alleviation, with positive consequences on patients' life quality.