Abstract

BackgroundPrevious studies have tried to relieve deafferentation pain (DP) by using virtual reality rehabilitation systems. However, the effectiveness of multimodal sensory feedback was not validated. The objective of this study is to relieve DP by neurorehabilitation using a virtual reality system with multimodal sensory feedback and to validate the efficacy of tactile feedback on immediate pain reduction.MethodsWe have developed a virtual reality rehabilitation system with multimodal sensory feedback and applied it to seven patients with DP caused by brachial plexus avulsion or arm amputation. The patients executed a reaching task using the virtual phantom limb manipulated by their real intact limb. The reaching task was conducted under two conditions: one with tactile feedback on the intact hand and one without. The pain intensity was evaluated through a questionnaire.ResultsWe found that the task with the tactile feedback reduced DP more (41.8 ± 19.8 %) than the task without the tactile feedback (28.2 ± 29.5 %), which was supported by a Wilcoxon signed-rank test result (p < 0.05).ConclusionsOverall, our findings indicate that the tactile feedback improves the immediate pain intensity through rehabilitation using our virtual reality system.Electronic supplementary materialThe online version of this article (doi:10.1186/s12984-016-0161-6) contains supplementary material, which is available to authorized users.

Highlights

  • Previous studies have tried to relieve deafferentation pain (DP) by using virtual reality rehabilitation systems

  • Because equivalent pain is induced by deafferentation such as brachial plexus avulsion as well as by amputation [2], we hereafter refer to the pain induced by deafferentation including amputation as deafferentation pain (DP)

  • Mirror visual feedback (MVF) therapy has been proposed for phantom limb pain treatment by Ramachandran et al [6, 7]

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Summary

Introduction

Previous studies have tried to relieve deafferentation pain (DP) by using virtual reality rehabilitation systems. The objective of this study is to relieve DP by neurorehabilitation using a virtual reality system with multimodal sensory feedback and to validate the efficacy of tactile feedback on immediate pain reduction. Phantom limb pain [1] is a common neuropathic pain syndrome following amputation [2], occurring in up to 80 % of patients [3, 4] It is differentiated from nonpainful phantom phenomena or residual-limb pain [5]. Mirror visual feedback (MVF) therapy has been proposed for phantom limb pain treatment by Ramachandran et al [6, 7]. Another study showed that MVF therapy has efficacy for DP caused by brachial plexus avulsion injury in addition to that by limb amputation [8]

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