Using visual illusion to reduce at-level neuropathic pain in paraplegia.

Full Abstract

Neuropathic pain after spinal cord injury is not well understood and is difficult to treat. One possible cause is mismatch between motor commands and sensory feedback. This two-part study in five paraplegic patients investigated whether a visual illusion aimed to correct this mismatch reduces pain. In study 1, patients undertook three conditions:
(i) virtual walking:
with a mirror placed in front of a screen, patients aligned their own upper body with a film of a lower body walking. Patients imagined walking and 'watched themselves' walk; (ii) guided imagery; (iii) watching a film. One patient withdrew from virtual walking because of distress. For all patients, the mean (95% CI) decrease in pain (100 mm VAS) was 42 mm (approximately 65%) (11-73 mm) for virtual walking, 18 mm (4-31 mm) for guided imagery and 4mm (-3 to 11 mm) for watching the film. Mean (95% CI) time to return to pre-task pain was 34.9 min (20.1-49.8 min) for virtual walking; 13.9 min (-0.9 to 28.8 min) for the guided imagery and 16.3 min (1.5-31.2 min) for the film. To investigate its clinical utility, four patients underwent virtual walking every weekday for 3 weeks. Mean (95% CI) decrease in pain was 53 mm (45-61 mm) at post training and 43 mm (27-58 mm) at 3-month follow-up. Virtual walking may be a viable treatment for pain after spinal cord injury. A clinical trial seems warranted.

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Author information

Author/s: Moseley, G Lorimer (GL);

Affiliation: Department of Physiology, Anatomy and Genetics and fMRIB Centre, University of Oxford, Le Gros Clark Building, South Parks Road, Oxford OX1 3QX, United Kingdom. lorimer.moseley(-atsign-)medsci.ox.ac.uk

Journal and publication information

Publication Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't

Journal: Pain (Pain), published in Netherlands. (Language: eng)

Reference: 2007-Aug; vol 130 (issue 3) : pp 294-8

Dates: Created 2007/07/02; Completed 2007/08/09;

PMID: 17335974, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Afferent Pathways - physiology
Efferent Pathways - physiology
Humans
Illusions
Imagery (Psychotherapy)
Imagination
Middle Aged
Neuralgia - etiology; rehabilitation; therapy

Neuralgia - etiology; rehabilitation; therapy
Paraplegia - complications; rehabilitation
Photic Stimulation
Physical Therapy Modalities
Psychomotor Performance
Spinal Cord Injuries - complications; rehabilitation
Treatment Outcome
User-Computer Interface
Walking

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