A virtual reality (VR) treatment developed for the treatment of phantom limb pain may reduce pain intensity and phantom sensations in some patients, according to a study published in Pain Medicine.

This study was conducted to assess the feasibility and progress of an intervention in which VR modeled after mirror therapy is used to reduce the intensity of phantom limb pain and associated sensations. Prior to receiving treatment, 14 veterans (average age, 63 years) with phantom limb pain (average intensity, 5 on a 0-10 scale) had a visit during which the amputation and phantom limb pain and sensations were evaluated.

The VR experience, which was based on mirror therapy, allowed patients to navigate a virtual environment while on a bicycle pedaler. Thanks to motion sensors on the pedaler, their cadence was mimicked by a virtual avatar, which allowed participants to visualize their own missing limb, intact and in motion.

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Ten of the participants completed the baseline visit and a single treatment session, and 4 completed additional sessions (5, 12, 14, and 28 sessions, respectively) at home or in the laboratory. Before beginning treatment, 57.1% of participants reported phantom limb pain, and 93% reported at least 1 unpleasant phantom sensation. Following VR treatment, 28.6% of patients still reported phantom limb pain (P =.02) and 28.6% reported phantom sensations (P =.001).

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After completing at least 1 treatment, participants were asked to rate the intervention on helpfulness, realism, immersion, and satisfaction, all of which were found to be “uniformly high to very high” across the small cohort. No adverse experiences were reported. These trends were maintained in participants who completed additional sessions.

Study limitations include a small sample size and a homogeneous population.

“With VR hardware and software technologies rapidly growing in quality in recent years while decreasing in cost, VR is an increasingly viable treatment approach for phantom limb pain. Although there are important methodological limitations to this preliminary study, the findings are supportive of future research,” concluded the study authors.

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Rutledge T, Velez D, Depp C, et al. A virtual reality intervention for the treatment of phantom limb pain: development and feasibility results [published online June 5, 2019]. Pain Med. doi:10.1093/pm/pnz121