HUMAN CENTERED DESIGN: VETERAN TESTING OF A MOBILE APP WITH AUGMENTED REALITY FOR PHANTOM LIMB PAIN

Phantom limb pain (PLP) after amputation is commonly experienced and can impact quality of life.[1] Management of PLP is challenging with few effective treatment options. One non-drug intervention is graded motor imagery (GMI) that includes 3-phases (i.e., limb laterality, motor imagery, and mirror therapy). Although clinicians report patient benefit from use of GMI, barriers exist to supporting at-home use of the intervention. This report focuses on refining a mobile app (VA-GMI) through serial cognitive interviews with 12 Veterans with transtibial amputation and PLP. Following each round of interviews, we summarized the major points to guide iterative changes in the mobile app. Our first round of interviews suggested that the Veterans find the VA-GMI app acceptable, but Veterans endorsed the need for added instructions. Concurrent with these enhancements, we worked to optimize the motor imagery and mirror therapy phases. We then invited Veterans to try the new version and repeated the process. Our second round of interviews suggested the need for additional education to support Veteran understanding of pain rehabilitation. This report describes the development and testing work to date using human centered design considerations. We anticipate we will reach consensus on the VA-GMI mobile app within the next iteration.