P26-21 Potential impact of mirror reflection-induced visual feedback on phantom limb awareness in forearm amputees

2010 ◽  
Vol 121 ◽  
pp. S262
Author(s):  
T. Mita ◽  
Y. Tobimatsu ◽  
N. Kawashima
2000 ◽  
Vol 14 (1) ◽  
pp. 73-76 ◽  
Author(s):  
K. Sathian ◽  
Arlene I. Greenspan ◽  
Steven L. Wolf

Arm amputees can experience the perception of movement of a phantom limb while looking at a mirror reflection of the moving, intact arm superimposed on the perceived phantom. Such use of a mirror to provide illusory visual feedback of move ment can be useful in rehabilitation of hemiparetic patients. In this case report, we de scribe the successful application of "mirror therapy" to the post-stroke rehabilitation of a patient with poor functional use of an upper extremity, due mainly to so matosensory deficits. Mirror therapy facilitated employment of a motor copy strategy (bimanual movements) and later progression to "forced use" of the affected arm. The end result was increased functional use of the affected upper limb.


2017 ◽  
Vol 42 (3) ◽  
pp. 288-298 ◽  
Author(s):  
Laura Herrador Colmenero ◽  
Jose Manuel Perez Marmol ◽  
Celia Martí-García ◽  
María de los Ángeles Querol Zaldivar ◽  
Rosa María Tapia Haro ◽  
...  

Background: Phantom limb pain is reported in 50%–85% of people with amputation. Clinical interventions in treating central pain, such as mirror therapy, motor imagery, or virtual visual feedback, could redound in benefits to amputee patients with phantom limb pain. Objectives: To provide an overview of the effectiveness of different techniques for treating phantom limb pain in amputee patients. Study design: Systematic review. Methods: A computerized literature search up to April 2017 was performed using the following databases: PubMed, Scopus, CINAHL, MEDLINE, ProQuest, PEDro, EBSCOhost, and Cochrane Plus. Methodological quality and internal validity score of each study were assessed using PEDro scale. For data synthesis, qualitative methods from the Cochrane Back Review Group were applied. Results: In all, 12 studies met our inclusion criteria, where 9 were rated as low methodological quality and 3 rated moderate quality. All studies showed a significant reduction in pain, but there was heterogeneity among subjects and methodologies and any high-quality clinical trial (PEDro score ≤8; internal validity score ≤5) was not found. Conclusion: Mirror therapy, motor imaginary, and virtual visual feedback reduce phantom limb pain; however, there is limited scientific evidence supporting their effectiveness. Future studies should include designs with more solid research methods, exploring short- and long-term benefits of these therapies. Clinical relevance This systematic review investigates the effectiveness of mirror therapy, motor imagery, and virtual visual feedback on phantom limb pain, summarizing the currently published trials and evaluating the research quality. Although these interventions have positive benefits in phantom limb pain, there is still a lack of evidence for supporting their effectiveness.


2017 ◽  
Vol 16 (1) ◽  
pp. 185
Author(s):  
Mikkel Thøgersen ◽  
John Hansen ◽  
Herta Flor ◽  
Lars Arendt-Nielsen ◽  
Laura Petrini

AbstractAimsVisual feedback is hypothesized to play an important role in the phantom limb condition. In this study we attempt to create an illusory experimental model of phantom limb wherein this condition is simulated by removing the visual input from the upper limb in a group of intact participants. The aim of the study is to investigate the role of visual feedback on somatosensation, nociception and bodily-self perception.MethodsUsing a novel mixed reality (MR) system, the visual feedback of the left hand is removed in order to visually simulate a left hand amputation on 30 healthy participants (15 females). Using a within-subject design, three conditions are created: visual amputation condition (MR with no visual input); visual condition (MR with normal vision); and a baseline condition (no MR). Thermal detection and nociceptive thresholds using method of limits are measured. Proprioception of the visually amputated hand is investigated by probing the felt hand position on a proximal-distal axis from the body. Using a questionnaire the effects of the missing visual feedback on bodily self is assessed.ResultsThere was a clear drift in proprioception of the left hand in the proximal direction between the control and visual amputation condition (p <0.001). A decrease in cold detection was also significant between the control and visual amputation condition (p < 0.001). Finally, questions on perceptual experiences indicated that the observed proprioceptive retraction of the visually amputated hand was also felt by the participants.ConclusionsMissing visual feedback greatly influences the perception of the visually amputated arm underlining the importance of visual feedback. The observed proprioceptive retraction of the hand resembles the telescoping perceptions often reported by phantom limb patients. The novel method developed for this study, is a new tool to investigate the influence of visual feedback on the relationship of bodily-self and chronic pain.


2017 ◽  
Vol 26 (6) ◽  
pp. 189-194
Author(s):  
Monika Žilionytė ◽  
Jurgita Savickaitė ◽  
Andrius Kederys ◽  
Lina Varžaitytė

Tyrimo tikslas – apžvelgti patikimais įrodymais pagrįstą literatūrą apie veidrodinės terapijos (VT) efektyvumą pacientams, persirgusiems galvos smegenų insultu. Tyrimo medžiaga ir metodai. Atliekant sisteminę apžvalgą, mokslinių straipsnių paieška vykdyta duomenų bazėse: PubMed, BioMedCentral, Tylor&amp;amp;Francis, CohraneLibrary, ScienceDirect. Mokslinių straipsnių paieška atlikta pagal kiekvienai duomenų bazei pritaikytą specialią paieškos strategiją. Paieškai buvo panaudoti šie raktažodžiai: „mirror therapy“, „rehabilitation“, „stroke“, „upper limb“, „recovery of function“, „mirror movement“, „phantom limb pain „, „mirror visual feedback“, „mirror neurons system“. Į sisteminę apžvalgą įtraukti anglų kalba 2008–2016 metais publikuoti atsitiktinių imčių kontroliuojami arba kontroliuojami prieš ir po tyrimai, kuriuose buvo vertinama VT įtaka paralyžiuotos galūnės motorinei ir sensorinei funkcijai, skausmo intensyvumui bei asocijuotos galvos smegenų žievės reorganizacijai. Tyrimo rezultatai. Į sisteminę apžvalgą įtraukta 11 tyrimų. Tyrimuose buvo suformuotos dvi grupės: tiriamųjų, kuriems buvo taikyta standartinė bei VT, ir kontrolinė grupė, kuriai buvo taikoma tik standartinė terapija. Daugelyje tyrimų VT taikyta vieną mėnesį. Rezultatai buvo vertinami prieš taikytą terapiją ir po jos. Apžvelgus visus šiuos 11 straipsnių stebime, kad tose tiriamųjų grupėse, kuriose naudojama VT, ženkliai pagerėja pacientų paralyžiuotos galūnės motorinė funkcija, padidėja vikrumas, sumažėja skausmas. Išvados. VT didina smegenų aktyvumą ipsilateralinėje motorinėje žievėje, somatosensorinėje zonoje, skatina asocijuotos žievės reorganizaciją, taip pat ji padeda pasiekti geresnių rezultatų pacientams, patyrusiems nedominuojančio pusrutulio insultą, sumažina persirgus insultu atsiradusį skausmą bei padidina po insulto sumažėjusį galūnių vikrumą. VT yra veiksminga ne tik gydant ūmiu ir poūmiu insultu, tačiau ir lėtiniu galvos smegenų insultu sergančius pacientus.


2009 ◽  
Vol 21 (11) ◽  
pp. 2207-2216 ◽  
Author(s):  
Pascale Touzalin-Chretien ◽  
Solange Ehrler ◽  
André Dufour

Phantom limb sensations may be linked to motor activities in the deafferented cortices of amputees, with artificial visual feedback of an amputated limb leading to enhanced phantom sensations. The present study was designed to verify if cortical motor activity related to an amputated limb can be triggered by visual input using an objective behavioral measure and with a neurophysiological correlate. Trauma amputees and normally limbed subjects showed superior performance in a mirror-drawing task when the mirror was placed sagittally (giving visual feedback of the amputated/inactive limb) compared with when it was placed frontally. Measurement of lateralized movement-related brain potentials showed that, under the lateral mirror condition, contralateral motor activity of the viewed hand was observed in both normal subjects and trauma amputees. In contrast, this activity was not observed in subjects with congenital limb absence. These findings suggest that, in traumatic amputees, motor enhancement due to visualization of the movements of the missing limb reflects the effectiveness of motor commands to the missing limb, strengthening the hypothesis of the functional survival of deafferented cortical motor areas.


2019 ◽  
Vol 62 (11) ◽  
pp. 4001-4014
Author(s):  
Melanie Weirich ◽  
Adrian Simpson

Purpose The study sets out to investigate inter- and intraspeaker variation in German infant-directed speech (IDS) and considers the potential impact that the factors gender, parental involvement, and speech material (read vs. spontaneous speech) may have. In addition, we analyze data from 3 time points prior to and after the birth of the child to examine potential changes in the features of IDS and, particularly also, of adult-directed speech (ADS). Here, the gender identity of a speaker is considered as an additional factor. Method IDS and ADS data from 34 participants (15 mothers, 19 fathers) is gathered by means of a reading and a picture description task. For IDS, 2 recordings were made when the baby was approximately 6 and 9 months old, respectively. For ADS, an additional recording was made before the baby was born. Phonetic analyses comprise mean fundamental frequency (f0), variation in f0, the 1st 2 formants measured in /i: ɛ a u:/, and the vowel space size. Moreover, social and behavioral data were gathered regarding parental involvement and gender identity. Results German IDS is characterized by an increase in mean f0, a larger variation in f0, vowel- and formant-specific differences, and a larger acoustic vowel space. No effect of gender or parental involvement was found. Also, the phonetic features of IDS were found in both spontaneous and read speech. Regarding ADS, changes in vowel space size in some of the fathers and in mean f0 in mothers were found. Conclusion Phonetic features of German IDS are robust with respect to the factors gender, parental involvement, speech material (read vs. spontaneous speech), and time. Some phonetic features of ADS changed within the child's first year depending on gender and parental involvement/gender identity. Thus, further research on IDS needs to address also potential changes in ADS.


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