Abstract
Background: Phantom limb pain can be defined as discomfort or pain in a missing part of the limb. The aims of this study were to develop and validate, through a Delphi methodology, a graded motor imagery protocol in order to reduce phantom limb pain. Method: Physiotherapists and/or occupational therapists with experience in research and a minimum clinical experience of five years in the field of neurorehabilitation and/or pain were recruited by part of a group of experts to assess the intervention. The study was conducted through an online questionnaire, where experts assessed each aspect of the intervention through a Likert scale. As many rounds as necessary were carried out until consensus was reached among experts. Results: A total of two rounds were required to fully validate the intervention. During the second round, the relative interquartile range of all aspects to be assessed was less than 15%, thus showing a consensus among experts and with good concordance (Kappa index of 0.76). Conclusion: Experts validated a graded motor imagery intervention of phantom limb pain in patients with amputations (GraMi protocol). This intervention can help to homogenize the use of graded motor imagery in future studies and in clinical practice.
Highlights
IntroductionPhantom limb pain (PLP) can be defined as discomfort or pain in a missing part of the limb [1]
The aim of the present study was to design and validate, by a committee of experts through a Delphi methodology, a graded motor imagery (GMI) intervention based on existing scientific evidence on the implementation of each of its techniques in people with Phantom limb pain (PLP)
Herrador Colmenero (2017) suggests that new treatment protocols should specify the GMI is a set of three techniques of progressive difficulty that the participant can pertype of intervention the frequency, duration, supervision and progression of the sessionsthe form and autonomously under professional and be active throughout process
Summary
Phantom limb pain (PLP) can be defined as discomfort or pain in a missing part of the limb [1]. It affects between 60% and 80% of people who have suffered an amputation but not with the same frequency and intensity [2]. There are different factors that influence the perception of pain, such as preamputation pain, location, sex, and time since the amputation, among others [3]. In 72% of cases, it appears in the week following the amputation [4]. In some cases, it can appear gradually over weeks, last over time, and become a chronic pain, causing a decrease in quality of life [2]
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