Home‐Based Tactile Discrimination Training Reduces Phantom Limb Pain

• Published in: Pain practice Vol. 18; no. 6; pp. 709 - 715
• Main Authors: Wakolbinger, Robert, Diers, Martin, Hruby, Laura A., Sturma, Agnes, Aszmann, Oskar C.
• Format: Journal Article
• Language: English
• Published: United States 01.07.2018
• Subjects: Adult; amputation; Amputation - adverse effects; body image; Female; Humans; Male; Middle Aged; Phantom Limb - prevention & control; phantom limb pain; Physical Stimulation - methods; physical therapy; Pilot Projects; Quality of Life; sensory discrimination training; telescoping; amputation; physical therapy; telescoping; body image; phantom limb pain; sensory discrimination training
• ISSN: 1530-7085; 1533-2500; 1533-2500
• DOI: 10.1111/papr.12657

Background Phantom limb pain (PLP) affects a high percentage of amputees. Since treatment options are limited, low quality of life and addiction to pain medication frequently occur. New treatments, such as mirror therapy or electrical sensory discrimination training, make use of the brain's plasticity to alleviate this centrally derived pain. Aim This pilot study assessed the question of whether home‐based tactile discrimination training (TDT) leads to a stronger decrease in PLP levels compared to standard massage treatment. Design Controlled study. Setting Outpatient. Population Amputees (upper/lower extremity) with a PLP score of 4 or higher out of a possible 10 points on the visual analog scale. Methods Eight patients participated in the study. The treatment phase comprised 2 weeks (15 minutes daily). Subjects were examined at baseline, after treatment, 2 weeks after completing treatment, and 4 weeks after completing treatment. Pain was assessed using the West Haven–Yale Multidimensional Pain Inventory. Results There was a significantly stronger reduction in PLP in the treatment group receiving TDT. PLP intensity ratings were significantly reduced at the end of therapy, and at 2 and 4 weeks after completing treatment compared to pretreatment. Conclusions TDT seems to be an easy, cheap, time‐effective, and safe method to achieve sustained alleviation of PLP and also brings about a positive change in body image. Rehabilitation Impact Home‐based TDT could achieve a sustained reduction in PLP and should be considered as a possible alternative to established treatment methods.