Body image and perception among adults with and without phantom limb pain

Abstract

Background Following lower‐limb amputation, phantom limb pain (i.e., pain perceived as coming from the amputated portion of the limb) is common. Phantom limb pain may be associated with impaired body image and perception, which may be targets for rehabilitative intervention. Objective To compare measures of body image and perception between adults with and without phantom limb pain post amputation and evaluate associations between measures of body image and perception and phantom limb pain. Design Survey. Setting Online, remote assessment. Participants Seventy‐two adults ≥1 year post unilateral lower‐limb loss (n = 42 with phantom limb pain, n = 30 without phantom limb pain or pain in the remaining portion of the limb). Interventions Not applicable. Main Outcome Measures Self‐reported outcome measures assessing body image (i.e., Amputee Body Image Scale‐Revised), perceptual disturbances associated with the phantom limb (i.e., a modified Bath Complex Regional Pain Syndrome Body Perception Disturbance Scale), and prosthesis satisfaction (i.e., Trinity Amputation and Prosthesis Experience Scale) were administered; participants with phantom limb pain reported pain interference via the Brief Pain Inventory‐Short Form. Between‐group comparisons of self‐reported outcome measure scores were conducted using Mann Whitney U or chi‐square tests, as appropriate (a = .05). Results Compared to peers without phantom limb pain, adults with phantom limb pain reported more negative body image; increased phantom limb ownership, attention, and awareness; and reduced prosthesis satisfaction and embodiment (U = 175.50–364.00, p < .001 to .034). Disturbances in phantom limb perception (i.e., size, weight, pressure, temperature) were similar between groups (p = .086 to >.999). More negative body image was associated with increased phantom limb pain interference (τb = .25, p = .026). Conclusions Adults with phantom limb pain demonstrate more negative body image and hypervigilance of the phantom limb as compared to peers with nonpainful phantom sensations. Mind‐body treatments that target impaired body image and perception may be critical interventions for adults with phantom limb pain.

Case Report: Phantom limb pain relief after cognitive multisensory rehabilitation

“…More specifically, she was able to produce a current multisensory motor imagery of her body along with the missing limb and produce correct memories and multisensory imagery of actions performed with the limb before the amputation. Based on our prior research, we hypothesize that these improvements are due to the restoration of the multisensory integration and MBR, possibly reflected by the reorganization of sensorimotor cortical areas, thereby reducing PLP ( 27 , 31 , 49 ).…”

Atividade física, ajuste à prótese e condição de saúde de pessoas com amputação de membro inferior

“…Sabe-se que pessoas com amputações, geralmente, apresentam quadros de ansiedade, depressão e baixa autoestima devido a sua condição física. 40 A atividade física é capaz de contribuir para a melhora desses aspectos psicológicos. 7,8 Bragaru et al 41 cita a atividade física como fator de influência na autoestima em pessoas com amputações, evidenciando níveis elevados de autoestima em indivíduos que praticam atividade física quando comparados aos não praticantes.…”

Chronic post amputation pain: pathophysiology and prevention options for a heterogenous phenomenon

“…The body schema is the dynamic representation of the properties of one's body. Conversely, amputation can negatively affect body image and perception, opening up a potential role for therapeutic approaches targeting self-image [50]. Therefore, several psychological treatment options for reducing PLP symptoms involve recreating the perceptions of body-ownership and agency.…”