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New wave of therapy for amputees

12 July 2017

Woman using virtual reality headset at night with city lights in background

Virtual Reality (VR) is a term that we have all been hearing a lot about lately, but the true extent of this tool can go much deeper than just a gaming gadget. VR has been adopted by various major industries such as NASA for navigating robots on Mars, courtrooms for better 3D imagery to assist the jury inter judgments, shopping, travel, automobile designs, educational facilities, museums and lastly the health industry which is already vastly benefiting from VR in many different areas.

The most innovative being the rehabilitation process for amputees experiencing phantom pain. Phantom pain is common amongst people who have had a limb amputated. By definition phantom pain, is a pain that comes from a body part that is no longer there. This pain may be shooting, sharp, burning, stabbing or throbbing sensation. The exact cause of phantom pain is still unknown but it appears to originate from the brain and spinal cord. As the nerve signals are abruptly stopped in the stump, signals are then sent to the brain alarming it that something must be wrong i.e. pain.

Up to 80% of amputees will have to deal with phantom pain at some point, although the duration, type, and intensity of pain will vary from person to person. No pain management methods have been proven to help amputees deal with phantom pain and often people revert to antidepressants or morphine. Neither of which actually reduce levels of pain nor create additional negative side effects. However, the growth of VR has opened up an exciting method of therapy for patients suffering from phantom pain as well as people affected by stroke, arthritis, disk disease, bone injuries and osteoporosis.

Benefits of VR in rehabilitation may be:

• Ecological validity i.e. results that can be generalized to real-life situations
• Stimulus control and consistency
• Real-time performance feedback
• Independent practice
• Stimulus and response modifications that are contingent on a user’s physical abilities
• A safe testing and training environment
• The opportunity for graduated exposure to stimuli
• The ability to distract or augment the performer’s attention
• Motivation for the performer

Dr Max Ortiz Catalan is a leading researcher in the field of phantom pain and VR. Max and his team designed a therapy that involves augmented reality, and tested it on a patient, whom had been struggling with phantom pain for over 48 years. Electrodes recorded muscle signals from the stump of the patient’s arm, and used software to convert those signals into movement of a virtual arm, superimposed over a video of the patient taken with a webcam. By thinking about moving his missing arm, the patient was able to control the virtual arm, using it to perform tasks such as driving a simulated car in a racing game. The patient reported that his pain gradually reduced, and he experienced pain-free periods over the course of his virtual reality treatments. He said his hand changed from feeling painfully clenched to feeling open and relaxed.

Even stroke patients are vastly improving their quality of life through the use of CAREN, Computer Assisted Rehabilitation Environment, post stroke victims have experienced positive results, taking a step further on the road to recovery. Psychological, physical, and cognitive benefits are all a part of engaging in VR activities as patients engage in Virtual Reality experiences. Research has found that VR and stroke rehabilitation has been effective in addressing motor deficits and shorten the recovery process for many patients, improving their motor functioning in ways that are not possible through physical therapy alone.

Virtual reality therapy for stroke victims has infinite possibly and potential. It was proven to help improve motor impairment as mentioned in a 2011 study published by the American Stroke Association found. In the 2011 study found that 11 out of 12 studies previous studies showed a significant benefit from rehabilitation with virtual reality.

This new wave of virtual reality based therapy will vastly shorten the rehabilitation process by optimising and expediting the recovery process. Hopefully, amputees will be able to access these therapeutic methods in the comfort of their own home one day and will be able to return back into society faster and live a fulfilled pain-free life they deserve.

By Emily Gray (Amputee Reintegration & Motivational Specialist) Emily Gray was diagnosed with an osteosarcoma at 11 years old which resulted in her having her left leg amputated through the hip. She then went on to represent South Africa at 3 Paralympic Games. She now helps amputees and cancer patients reintegrate back into society by looking at their physical and mental wellbeing.