Perioperative Mirror Therapy and Phantom Limb Pain
Phantom Limb Pain, Phantom Pain, Phantom Sensation
About this trial
This is an interventional treatment trial for Phantom Limb Pain focused on measuring Phantom limb pain, Mirror therapy, Elective amputation, Residual limb pain, Functional MRI
Eligibility Criteria
Inclusion Criteria:
Treatment (Surgical) Group:
- Subjects age 18 years or older scheduled for elective amputation;
- Cooperative, patient scheduled for amputation, with time and availability to do fMRI prior to their operative date;
- Willing to perform mirror therapy for 14 days prior and post-operative procedure;
- Subjects who opt for fMRI portion of the study are willing and/or able to tolerate fMRI.
Control (Non-Surgical) Group:
- Subjects age 18 years to 30;
- who are non amputated and healthy;
- Cooperative, with time and availability to do an fMRI;
- Willing and able to tolerate fMRI.
Exclusion Criteria:
- inability to cooperate with physical therapy; and
- possessing a contraindication to mirror therapy for example blindness or inability to position properly for the therapy
- primary central nervous disease such as status post cerebral vascular accident with persistent deficit, Alzheimer's disease or Multiple Sclerosis. In addition, patients with claustrophobia will be excluded from participating in the fMRI portion of this study.
Sites / Locations
- Pain Medicine Center, Department of Anesthesiology, Naval Medical Center San DiegoRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Sham Comparator
Experimental
No Intervention
Plasma Ball (Control)
Experimental
Non-Surgical
Subjects randomized to standard therapy will participate 14 days of daily mirror therapy sessions preoperatively which will consist of undergoing a sham therapy with a 22" plasma globe involving contralateral limb interaction with the sphere.
Subjects randomized to the mirror therapy limb will undergo 14 days of daily mirror therapy sessions preoperatively which will consist of observing the unaffected limb reflected for 30 minutes in a mirror positioned in the midline to block the view of the affected limb.
Subjects will undergo 3 questionnaires and one functional fMRI exam. Imaging protocol will be identical to preoperative imaging protocol for amputation subjects. This data will aid in establishing baseline fMR activation values for all fMR paradigms tested. The control group will not be randomized to receive either perioperative plasma ball (sham) or mirror therapy.