The missing link: How is the phantom limb influenced by prosthesis wearing in people with lower-limb amputation?

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Prosthetics Engineering

Background:

• Therapeutic and technological advancements aim to enhance daily living for individuals with limb amputation.
• Focus on managing phantom limb phenomena, including painless phantom sensations (PS) and voluntary phantom movements (VPM).

Purpose of the Study:

• Investigate the impact of prosthesis wearing on painless PS, painful PS, and VPM in lower-limb amputees.
• Explore how prosthetic use influences subjective phantom limb experiences.

Main Methods:

• Cross-sectional study utilizing semi-directed interviews with 111 individuals with major lower-limb amputations.
• Participants described their phantom limb sensations with and without prosthesis in a static, seated position.
• Influence of prosthesis on PS and VPM was categorized into disappearance, decrease, modification, increase, or appearance.

Main Results:

• Prosthesis wearing predominantly increased painless PS intensity (44%) and improved VPM ability (47%).
• A significant decrease in painful PS intensity was observed in 44% of participants.
• Prosthesis-related changes extended to phantom limb position, shape, and size, potentially linked to socket pressure on the residual limb.

Conclusions:

• Prosthesis use significantly influences phantom limb sensations and movements in lower-limb amputees.
• Findings offer valuable insights for integrating prosthetic considerations into research, engineering, and rehabilitation strategies.
• Understanding the prosthesis-phantom limb interaction can lead to improved patient outcomes and prosthetic design.