Skip to main content
SpringerLink
Log in
Book cover

Amputation, Prosthesis Use, and Phantom Limb Pain pp 175–196Cite as

Virtual Solutions to Phantom Problems: Using Immersive Virtual Reality to Treat Phantom Limb Pain

  • Chapter
  • First Online:

Abstract

Phantom limb pain (PLP) is a common consequence of amputation, and many persons with amputations experience vivid sensations of pain in the absent body part. PLP can persist for many years post-amputation and is very difficult to treat, since its aetiology is hard to determine. However, converging lines of evidence demonstrate that when visual feedback is manipulated appropriately to represent movement of an amputee’s absent limb, it can evoke kinesthetic sensations of movement in that limb and decrease PLP. Most notably, the mirror box – where a mirror is placed vertically in front of the person with an amputation – is used in such a way as to reflect the image of an intact limb onto the phenomenal space of the absent or phantom limb. When amputees orient towards this mirror image kinaesthetic sensations can be evoked in the muscles and joints of their phantom limb, and PLP can be decreased.

Some researchers have highlighted limitations in the flexibility of the mirror box in providing a fully robust illusion of an absent limb as intact. Recently, three research groups have developed virtual reality systems informed by mirror-box work for the treatment of PLP. Although similar in intent and design, these systems have subtle differences. This chapter will outline these systems along with empirical findings, with a particular emphasis on the authors’ own virtual reality system.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   89.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Blakemore SJ, Wolpert DA, Frith CD (2002) Abnormalities in the awareness of action. Trends Cognitive Sci 6:237–242

    Article  Google Scholar 

  • Botvinik M, Cohen J (1998) Rubber hands “feel” touch that eyes see. Nature 391(6669):756

    Article  Google Scholar 

  • Brodie EE, Whyte A, Waller B (2003) Increased motor control of a phantom leg in humans results from the visual feedback of a virtual leg. Neurosci Lett 341(2):167–169

    Article  PubMed  CAS  Google Scholar 

  • Cole J, Crowle S, Austwick G, Henderson Slater D (2009) Exploratory findings with virtual reality for phantom limb pain; from stump motion to agency and analgesia. Disabil Rehabil 31(10):846–854

    Google Scholar 

  • Desmond D, O’Neill K, De Paor A, McDarby G, MacLachlan M (2006) Augmenting the reality of phantom limbs: Three case studies using an augmented mirror-box procedure. J Prosthet Orthot 18(3):74–79

    Article  Google Scholar 

  • Giraux P, Sirigu A (2003) Illusory movements of the paralyzed limb restore motor cortex activity. NeuroImage 20:S107–S111

    Article  PubMed  Google Scholar 

  • Katz J (1992) Psychophysiological contribution to phantom limbs. Can J Psychiatr 37:282–298

    CAS  Google Scholar 

  • Kuttuva M, Flint JA, Burdea G, Phillips SLP, Craelius W (2003) VIA: A virtual interface for the arm of upper-limb amputees. Proc Second Int Workshop Virtual Rehabil:119–126

    Google Scholar 

  • Kuttuva M, Flint JA, Burdea G, Phillips SL, Craelius W (2005) Manipulation practice for upper-limb amputees using virtual reality. Published by Rutgers University, NJ, USA. Presence 14(2):175–182

    Article  Google Scholar 

  • MacLachlan M, McDonald M, Waloch J (2004) Mirror treatment of lower limb phantom pain: A case study. Disabil Rehabil 26:901–904

    Article  PubMed  Google Scholar 

  • McCabe CS, Haigh RC, Halligan P, Blake DR (2005) Simulating sensory-motor incongruence in health volunteers: Implications for a cortical model of pain. Rheumatology 44:509–516

    Article  PubMed  CAS  Google Scholar 

  • Moseley GL, Gallace A, Spence C (2008) Is mirror therapy all it is cracked up to be? Current evidence and future directions. Pain 138:7–10

    Article  PubMed  Google Scholar 

  • Murray CD (2004) An interpretative phenomenological analysis of the embodiment of artificial limbs. Disability and Rehabilitation 26(16):963–973

    Google Scholar 

  • Murray CD, Pettifer S, Caillette F, Patchick E, Howard T (2005) Immersive virtual reality as a rehabilitative technology for phantom limb experience. University of Southern California, Los Angeles, CA, USA Proc Fourth Int Workshop Virtual Real:144–151

    Google Scholar 

  • Murray CD, Patchick E, Pettifer S, Caillette F, Howard T (2006a) Immersive virtual reality as a rehabilitative technology for phantom limb experience: A protocol. Cyberpsychol Behav 9(2):167–170

    Article  PubMed  Google Scholar 

  • Murray CD, Patchick E, Caillette F, Howard T, Pettifer S (2006b) Can immersive virtual reality reduce phantom limb pain? In: Westwood JD, Haluck RS, Hoffman HM, Mogel GT, Phillips R, Robb RA, Vosburgh KG (eds) Medicine meets virtual reality: Accelerating change in healthcare: Next medical toolkit. IOS Press, Amsterdam, pp 407–412

    Google Scholar 

  • Murray CD, Patchick EL, Pettifer S, Howard T, Caillette F, Kulkarni J, Bamford C (2006c) Investigating the efficacy of a virtual mirror-box in treating phantom limb pain in a sample of chronic sufferers. Int J Disabil Hum Dev 5:227–234

    Google Scholar 

  • Murray CD, Pettifer S, Howard T, Patchick EL, Caillette F, Kulkarni J, Bamford C (2007) The treatment of phantom limb pain using immersive virtual reality: Three case studies. Disabil Rehabil 29:1465–1469

    Article  PubMed  Google Scholar 

  • O’Neill K, de Paor A, MacLachlan M, McDarby G (2003) An investigation into the performance of a virtual mirror-box for the treatment of phantom limb pain in amputees using augmented reality technology. In: Human-computer-interaction international 2003, conference proceedings. Lawrence Erlbaum Associates Inc., London

    Google Scholar 

  • Phillips H (2000) They do it with mirrors – Who’d have thought that you could make the brain pay attention to a useless limb, or even exercise a phantom one, with only a mirror for help. New Sci 166:26–29

    Google Scholar 

  • Popescu VG, Burdea GC, Bouzit M, Hentz VR (2000) A virtual-reality-based telerehabilitation system with force feedback. IEEE Transactions on Information Technology in Biomedicine 4(1):45–51

    Google Scholar 

  • Ramachandran VS (2005) Plasticity and functional recovery in neurology. Clin Med 5(4):368–373

    PubMed  CAS  Google Scholar 

  • Ramachandran VS, Rogers-Ramachandran D (1996) Synaesthesia in phantom limbs induced with mirrors. Proc R Soc Lon, B Biol Sci 263:377–386

    Article  CAS  Google Scholar 

  • Rosen B, Lundborg G (2005) Training with a mirror in rehabilitation of the hand. Scand J Plast Reconstr Surg Hand Surg 39(2):104–108

    Article  PubMed  Google Scholar 

  • Sathian K, Greenspan AI, Wolf SL (2000) Doing it with mirrors: A case study of a novel approach to rehabilitation. Neurorehabil Neural Repair 14(1):73–76

    Article  PubMed  CAS  Google Scholar 

  • Sherman RA, Sherman CJ, Parker L (1984) Chronic phantom and stump pain among American veterans: results of a survey. Pain 18:83–89

    Article  PubMed  CAS  Google Scholar 

  • Stevens JA, Phillips Stoykov ME (2003) Using motor imagery in the rehabilitation of hemiparesis. Arch Phys Med Rehabil 84:1090–1092

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Health and Medicine, Lancaster University, Lancaster, UK

    Craig D. Murray

Authors
  1. Craig D. Murray
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stephen Pettifer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Toby Howard
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Emma Patchick
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fabrice Caillette
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Joanne Murray
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Craig D. Murray .

Editor information

Editors and Affiliations

  1. Dept. Psychology, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom

    Craig Murray

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Murray, C.D., Pettifer, S., Howard, T., Patchick, E., Caillette, F., Murray, J. (2009). Virtual Solutions to Phantom Problems: Using Immersive Virtual Reality to Treat Phantom Limb Pain. In: Murray, C. (eds) Amputation, Prosthesis Use, and Phantom Limb Pain. Springer, New York, NY. https://doi.org/10.1007/978-0-387-87462-3_12

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-87462-3_12

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-87461-6

  • Online ISBN: 978-0-387-87462-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation