Targeted Brain Rehabilitation: Development, Feasibility, and Usability of a Novel Virtual Reality System for Phantom Limb Pain Management and Amputee Rehabilitation
Phantom limb pain (PLP), which affects up to 1.6 million amputees in the United States, is often inadequately controlled with current treatment strategies. Although surgical interventions like targeted muscle reinnervation and regenerative peripheral nerve interfaces can effectively address peripher...
Uloženo v:
| Vydáno v: | The Journal of hand surgery (American ed.) |
|---|---|
| Hlavní autoři: | , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
United States
04.11.2025
|
| Témata: | |
| ISSN: | 1531-6564, 1531-6564 |
| On-line přístup: | Zjistit podrobnosti o přístupu |
| Tagy: |
Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
|
| Abstract | Phantom limb pain (PLP), which affects up to 1.6 million amputees in the United States, is often inadequately controlled with current treatment strategies. Although surgical interventions like targeted muscle reinnervation and regenerative peripheral nerve interfaces can effectively address peripheral pain generators, the central mechanisms of PLP require complementary treatment approaches. This study introduces targeted brain rehabilitation (TBR), a novel virtual reality system designed to address the limitations of current therapies and provide a comprehensive, accessible solution for PLP management. Targeted brain rehabilitation incorporates a structured, four-phase approach aimed at gradually engaging the plasticity of cortical regions involved in phantom limb perception and pain.
A two-phase study was conducted: (1) a survey of 36 upper-extremity amputees to inform the design of the TBR system, and (2) a single-session feasibility and usability study with 10 upper-extremity amputees. The TBR system incorporates four phases: laterality recognition, guided meditation, virtual mirror feedback, and guided motor execution, each targeting specific cortical regions and mechanisms implicated in PLP.
The survey revealed that ease of use (77.8%) and decreased PLP (58.3%) were the most desired features and treatment outcomes, respectively. The TBR system demonstrated excellent usability (system usability scale: 87.8 ± 10.6), minimal simulator sickness (simulator sickness questionnaire: 0.7 ± 2.4), and considerable pain reduction (numeric pain rating scale decreased from 5.0 ± 2.0 to 2.0 ± 1.6). Participants identified the guided motor execution phase as most helpful for phantom limb position (60%), control (70%), and pain reduction (60%). Notably, 90% of participants reported changes in phantom limb position after a single-session.
The TBR system shows promise as an engaging, accessible, and potentially effective treatment for PLP, addressing both somatosensory and kinesthetic symptoms. By leveraging principles of neuroplasticity and cortical reorganization, TBR offers a novel approach to PLP management.
Therapeutic IV. |
|---|---|
| AbstractList | Phantom limb pain (PLP), which affects up to 1.6 million amputees in the United States, is often inadequately controlled with current treatment strategies. Although surgical interventions like targeted muscle reinnervation and regenerative peripheral nerve interfaces can effectively address peripheral pain generators, the central mechanisms of PLP require complementary treatment approaches. This study introduces targeted brain rehabilitation (TBR), a novel virtual reality system designed to address the limitations of current therapies and provide a comprehensive, accessible solution for PLP management. Targeted brain rehabilitation incorporates a structured, four-phase approach aimed at gradually engaging the plasticity of cortical regions involved in phantom limb perception and pain.
A two-phase study was conducted: (1) a survey of 36 upper-extremity amputees to inform the design of the TBR system, and (2) a single-session feasibility and usability study with 10 upper-extremity amputees. The TBR system incorporates four phases: laterality recognition, guided meditation, virtual mirror feedback, and guided motor execution, each targeting specific cortical regions and mechanisms implicated in PLP.
The survey revealed that ease of use (77.8%) and decreased PLP (58.3%) were the most desired features and treatment outcomes, respectively. The TBR system demonstrated excellent usability (system usability scale: 87.8 ± 10.6), minimal simulator sickness (simulator sickness questionnaire: 0.7 ± 2.4), and considerable pain reduction (numeric pain rating scale decreased from 5.0 ± 2.0 to 2.0 ± 1.6). Participants identified the guided motor execution phase as most helpful for phantom limb position (60%), control (70%), and pain reduction (60%). Notably, 90% of participants reported changes in phantom limb position after a single-session.
The TBR system shows promise as an engaging, accessible, and potentially effective treatment for PLP, addressing both somatosensory and kinesthetic symptoms. By leveraging principles of neuroplasticity and cortical reorganization, TBR offers a novel approach to PLP management.
Therapeutic IV. Phantom limb pain (PLP), which affects up to 1.6 million amputees in the United States, is often inadequately controlled with current treatment strategies. Although surgical interventions like targeted muscle reinnervation and regenerative peripheral nerve interfaces can effectively address peripheral pain generators, the central mechanisms of PLP require complementary treatment approaches. This study introduces targeted brain rehabilitation (TBR), a novel virtual reality system designed to address the limitations of current therapies and provide a comprehensive, accessible solution for PLP management. Targeted brain rehabilitation incorporates a structured, four-phase approach aimed at gradually engaging the plasticity of cortical regions involved in phantom limb perception and pain.PURPOSEPhantom limb pain (PLP), which affects up to 1.6 million amputees in the United States, is often inadequately controlled with current treatment strategies. Although surgical interventions like targeted muscle reinnervation and regenerative peripheral nerve interfaces can effectively address peripheral pain generators, the central mechanisms of PLP require complementary treatment approaches. This study introduces targeted brain rehabilitation (TBR), a novel virtual reality system designed to address the limitations of current therapies and provide a comprehensive, accessible solution for PLP management. Targeted brain rehabilitation incorporates a structured, four-phase approach aimed at gradually engaging the plasticity of cortical regions involved in phantom limb perception and pain.A two-phase study was conducted: (1) a survey of 36 upper-extremity amputees to inform the design of the TBR system, and (2) a single-session feasibility and usability study with 10 upper-extremity amputees. The TBR system incorporates four phases: laterality recognition, guided meditation, virtual mirror feedback, and guided motor execution, each targeting specific cortical regions and mechanisms implicated in PLP.METHODSA two-phase study was conducted: (1) a survey of 36 upper-extremity amputees to inform the design of the TBR system, and (2) a single-session feasibility and usability study with 10 upper-extremity amputees. The TBR system incorporates four phases: laterality recognition, guided meditation, virtual mirror feedback, and guided motor execution, each targeting specific cortical regions and mechanisms implicated in PLP.The survey revealed that ease of use (77.8%) and decreased PLP (58.3%) were the most desired features and treatment outcomes, respectively. The TBR system demonstrated excellent usability (system usability scale: 87.8 ± 10.6), minimal simulator sickness (simulator sickness questionnaire: 0.7 ± 2.4), and considerable pain reduction (numeric pain rating scale decreased from 5.0 ± 2.0 to 2.0 ± 1.6). Participants identified the guided motor execution phase as most helpful for phantom limb position (60%), control (70%), and pain reduction (60%). Notably, 90% of participants reported changes in phantom limb position after a single-session.RESULTSThe survey revealed that ease of use (77.8%) and decreased PLP (58.3%) were the most desired features and treatment outcomes, respectively. The TBR system demonstrated excellent usability (system usability scale: 87.8 ± 10.6), minimal simulator sickness (simulator sickness questionnaire: 0.7 ± 2.4), and considerable pain reduction (numeric pain rating scale decreased from 5.0 ± 2.0 to 2.0 ± 1.6). Participants identified the guided motor execution phase as most helpful for phantom limb position (60%), control (70%), and pain reduction (60%). Notably, 90% of participants reported changes in phantom limb position after a single-session.The TBR system shows promise as an engaging, accessible, and potentially effective treatment for PLP, addressing both somatosensory and kinesthetic symptoms. By leveraging principles of neuroplasticity and cortical reorganization, TBR offers a novel approach to PLP management.CONCLUSIONSThe TBR system shows promise as an engaging, accessible, and potentially effective treatment for PLP, addressing both somatosensory and kinesthetic symptoms. By leveraging principles of neuroplasticity and cortical reorganization, TBR offers a novel approach to PLP management.Therapeutic IV.TYPE OF STUDY/LEVEL OF EVIDENCETherapeutic IV. |
| Author | Gaston, R Glenn Loeffler, Bryan J Siebert, Marcie Ahn, Grace Serbin, Ryan P Johnsen, Kyle Bowmar, Ethan Frix, James T |
| Author_xml | – sequence: 1 givenname: Ryan P surname: Serbin fullname: Serbin, Ryan P organization: Atrium Health Musculoskeletal Institute, Charlotte, NC – sequence: 2 givenname: James T surname: Frix fullname: Frix, James T organization: Atrium Health Musculoskeletal Institute, Charlotte, NC – sequence: 3 givenname: Ethan surname: Bowmar fullname: Bowmar, Ethan organization: Center for Advanced Computer-Human Ecosystems, University of Georgia, Athens, GA – sequence: 4 givenname: Kyle surname: Johnsen fullname: Johnsen, Kyle organization: Center for Advanced Computer-Human Ecosystems, University of Georgia, Athens, GA; OrthoCarolina Reconstructive Center for Lost Limbs, Charlotte, NC – sequence: 5 givenname: Marcie surname: Siebert fullname: Siebert, Marcie organization: PT Solutions, Charlotte Hand Center, Charlotte, NC – sequence: 6 givenname: Grace surname: Ahn fullname: Ahn, Grace organization: Center for Advanced Computer-Human Ecosystems, University of Georgia, Athens, GA – sequence: 7 givenname: Bryan J surname: Loeffler fullname: Loeffler, Bryan J email: bryan.loeffler@orthocarolina.com organization: Atrium Health Musculoskeletal Institute, Charlotte, NC; OrthoCarolina Reconstructive Center for Lost Limbs, Charlotte, NC; OrthoCarolina Research Institute, Charlotte, NC. Electronic address: bryan.loeffler@orthocarolina.com – sequence: 8 givenname: R Glenn surname: Gaston fullname: Gaston, R Glenn organization: Atrium Health Musculoskeletal Institute, Charlotte, NC; OrthoCarolina Reconstructive Center for Lost Limbs, Charlotte, NC; OrthoCarolina Research Institute, Charlotte, NC |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/41186547$$D View this record in MEDLINE/PubMed |
| BookMark | eNpdkMlOwzAQQC0EAgr8AAfkI4c2eInTlBuUVSqLoOVajd0JdZXYJXaQ-j98KKGAhDjNSPPmzdIhm847JOSQs4Qznp0sksU8QCKYUAnLE8bFBtnlSvJeprJ080--QzohLBhru6TaJjsp53mm0v4u-RhD_YoRZ_S8BuvoE85B29JGiNa7U3qB71j6ZYUudukVQrDr6qpLwc3oJHzDK-oLCvTetzB9sXVsoGxVsC49r0LEiha-po9zcNFXdGQrTR-_5t2Bg1f80q-FZ9WyiYj_1tgnWwWUAQ9-4h6ZXF2Ohze90cP17fBs1DO8PaYHOiu0goJzYYyUgxQV67NcZkYqozXLBZcDyY02Ik_zAkQmDBpEmGnsMz4Qe-T427us_VuDIU4rGwyWJTj0TZhKkeVp2udKtOjRD9roCmfTZW0rqFfT38-KT3ZdgEk |
| ContentType | Journal Article |
| Copyright | Copyright © 2025 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved. |
| Copyright_xml | – notice: Copyright © 2025 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved. |
| DBID | NPM 7X8 |
| DOI | 10.1016/j.jhsa.2025.08.012 |
| DatabaseName | PubMed MEDLINE - Academic |
| DatabaseTitle | PubMed MEDLINE - Academic |
| DatabaseTitleList | PubMed MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| EISSN | 1531-6564 |
| ExternalDocumentID | 41186547 |
| Genre | Journal Article |
| GroupedDBID | --- --K .1- .FO 0R~ 123 1B1 1P~ 1~5 4.4 457 4G. 7-5 AAEDT AAEDW AALRI AAXUO ABLJU ABMAC ADBBV AEVXI AFJKZ AFRHN AFTJW AHHHB AHMBA AITUG AJUYK ALMA_UNASSIGNED_HOLDINGS AMRAJ APXCP BELOY CS3 EBS EFJIC EFKBS F5P FDB G-Q GBLVA IHE J1W K-O L7B NPM O9- OF0 OR. PQQKQ ROL RPZ RWL SDG SEL SES SEW SJN SSZ TAE UV1 XH2 Z5R 7X8 |
| ID | FETCH-LOGICAL-c1547-ab6fb5af112cc3394e5070836c35cbb08213931cbc2848fa262ceceeadbe70192 |
| IEDL.DBID | 7X8 |
| ISSN | 1531-6564 |
| IngestDate | Tue Nov 04 16:36:34 EST 2025 Wed Nov 05 01:52:28 EST 2025 |
| IsPeerReviewed | true |
| IsScholarly | true |
| Keywords | virtual reality graded motor imagery phantom limb pain Amputee mirror therapy |
| Language | English |
| License | Copyright © 2025 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c1547-ab6fb5af112cc3394e5070836c35cbb08213931cbc2848fa262ceceeadbe70192 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| PMID | 41186547 |
| PQID | 3268447152 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_3268447152 pubmed_primary_41186547 |
| PublicationCentury | 2000 |
| PublicationDate | 2025-Nov-04 |
| PublicationDateYYYYMMDD | 2025-11-04 |
| PublicationDate_xml | – month: 11 year: 2025 text: 2025-Nov-04 day: 04 |
| PublicationDecade | 2020 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States |
| PublicationTitle | The Journal of hand surgery (American ed.) |
| PublicationTitleAlternate | J Hand Surg Am |
| PublicationYear | 2025 |
| SSID | ssj0001635 |
| Score | 2.4591687 |
| SecondaryResourceType | online_first |
| Snippet | Phantom limb pain (PLP), which affects up to 1.6 million amputees in the United States, is often inadequately controlled with current treatment strategies.... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| Title | Targeted Brain Rehabilitation: Development, Feasibility, and Usability of a Novel Virtual Reality System for Phantom Limb Pain Management and Amputee Rehabilitation |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/41186547 https://www.proquest.com/docview/3268447152 |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1LS8NAEF7UevDiA1_1xQgeG2zzauJFqlg8aAjSSm9hd7NLKzSpTRX6f_yhzmxSqoIgeMkp2Sw7szPf7s5-H2MXHkfMoNwmWsDhlqv8wAq0lpYMEG40lcaQKIzYRDuKgsEgjKsNt6Iqq1zERBOo01zSHvmlQ7QkGEk9-3ryapFqFJ2uVhIaq6zmYNvk1e3Bki0csYZX8qW2LMQtbnVppqzvehkWxDtke4bCkxQpf4OYJtV0t_7byW22WYFM6JRescNWVLbLPnqm6FulcEOyEPD0jaP7Cr6UDzUAkWFVNztvAM9S6JdUvLM55Bo4RDm-DM-jKV0_waYMmoeS_hwQB0M8JHXiMTyMxgJi-t-y0MY02DFqEupHN_ZYv3vXu723Ko0GSyL4altc-Fp4XCNsk9JxQlchwCTGa-l4UggEGGgXpyWFxDwYaG77tlSYmHkqFDHB2_tsLcszdchASyUCbdtB4CnamOKOVrh-Jga3UPqhV2fni0FPcA7QwQbPVP5WJMthr7OD0nLJpCTrSFxcQZHA8tEfvj5mG-QQ5qqhe8JqGiOAOmXr8n02KqZnxrnwGcWPn8uo254 |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Targeted+Brain+Rehabilitation%3A+Development%2C+Feasibility%2C+and+Usability+of+a+Novel+Virtual+Reality+System+for+Phantom+Limb+Pain+Management+and+Amputee+Rehabilitation&rft.jtitle=The+Journal+of+hand+surgery+%28American+ed.%29&rft.au=Serbin%2C+Ryan+P&rft.au=Frix%2C+James+T&rft.au=Bowmar%2C+Ethan&rft.au=Johnsen%2C+Kyle&rft.date=2025-11-04&rft.issn=1531-6564&rft.eissn=1531-6564&rft_id=info:doi/10.1016%2Fj.jhsa.2025.08.012&rft.externalDBID=NO_FULL_TEXT |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1531-6564&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1531-6564&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1531-6564&client=summon |