The German GAPP project developed a prototype virtual reality (VR) training to help relieve phantom limb pain in amputees. Patients who used the training were more motivated to undertake exercise programs and thereby ensure the long-term success of their therapy.
- 14 July 2020
The integration of innovative technologies, such as virtual reality training programs and gamification, is expected to provide cost-effective care solutions to reduce the intensity of phantom pain that limits day-to-day activities
Phantom limb pain can be reduced by using mirror therapy. This involves placing a mirror between the patient’s arm or leg and the amputated limb. The patient then sees the reflection of the intact limb in the place where the amputated limb used to be. When the patient performs exercises with the arm or leg, it tricks the brain into thinking that movement has occurred without pain in the phantom limb.
The Gamification Against Phantom Pain project, based in the German state of North Rhine-Westphalia, used VR instead of a mirror to achieve this. GAPP’s VR training prototype comes in both German and English language versions. Therapists in clinics across Germany evaluated the prototype for ease of use and technical functionality.
GAPP built on a previous project, Patient Centred Telerehabilitation, during which patients and therapists were interviewed to study rehabilitation exercises for arm or leg amputees.
Unbearable pain
Phantom pain causes amputees to feel pain where the amputated limb was. It can severely impede daily activities. The traditional solution has been drug therapy, which is expensive, can lead to side-effects and provides only short-term relief.
Four out of five amputees report partial or unbearable pain in a phantom limb. The sensation varies in nature and intensity, occurring continuously over hours or in short attacks of stabbing pain. Much needs to be done to better understand this condition, though there are indications that the central nervous system plays a key role.
The brain’s body map
Research shows that brains contain a kind of 'body map', and the more a body part is used, the more it is ‘anchored’ in the brain. If a limb is used less, this affects the map.
As an example, think of a watch that you wear on your wrist for a while. At some point you will not feel it anymore. You only notice it when you take it off. Only when a body part is no longer there and the system is out of balance, does it becomes a conscious sensation.
Total investment and EU funding
Total investment for the project “GAPP – Gamification Against Phantom Pain” is EUR 873 327, with the EU’s European Regional Development Fund contributing EUR 436 664 through the “Nordrhein-Westfalen ERDF” Operational Programme for the 2014-2020 programming period. The investment falls under the priority ‘Strengthening of research, technological development and innovation’.