PowerPoint Presentation

Phantom Limb Pain

Marc JohnsonRationale, Purpose, and SummaryPersonal connection to this topic and this pain is common in a majority of amputees

The purpose of this study was to evaluate the successfulness of mirror therapy on amputee patients

This study looked at 80 amputees. 39 were part of the control and 41 part of mirror therapy.

Background Information It is not fully understood why phantom limb pain is felt in amputees.

What is Mirror Therapy?

Mirror Therapy is not fully understood but there are many theories on why it has been successful for some patients.

3Nursing Care Problem

Very prevalent in patients who undergo an amputation.

Lack of understanding.

Patient education is necessary.

Nursing TheoryGate Control Theory

Written in 1965 by Melzack and WallIt describes a gate located in the spinal cord that opens and closes which modifies the perception of painMelzack suggests that a psychological factor plays a role in pain perception. Things that can close the gateMedicationBeing in a good moodConcentrating on things other then the injury

Methods & ResultsThis study included 80 amputee patients (41 mirror therapy and 39 control group).

Participants were asked to perform 10 different exercise

Both the control and test groups had more control over pain. Mirror therapy does not reduce phantom limb pain any more than exercises on there own.

The presence of a phantom limb (PLA), defined asthe conscious awareness of the missing leg, phantomsensations (PLS), defined as the perception of nonpainfulsensations such as heat, cold or itch in thephantom leg, and phantom pain (PLP), defined as theperception of painful sensations in the phantom leg,were each recorded immediately before and after theintervention to tease apart the complex subjective experienceof a phantom limb6Critique A larger test pool could have been used.

Grouping amputation types (Ex. All elective leg amputation in one group)

A follow up study to see if phantom pain returned on patients who found relief using mirror therapy.

Patient Care Design Nurses would collaborate with:

A orthotic and prosthetic specialistPain specialist Physical and occupational therapyTherapist

Nursing Diagnosis Chronic pain related to phantom limb sensation/pain

Nursing interventionsEducation on the variety of therapies offeredPain medications Learn if there is a trigger to the pain along with location, duration, and level of pain

Advocate RoleThis pain might be hard to understand and may be hard for the patient to explain but the pain is real and pain medication should be administered.

Every patient is different

Often pain is described as shooting, stabbing, burning, cramping.

Education

10ReferencesBrodie, E., Whyte, A., Niven, C. (2007). Analgiea through the looking glass? A randomized controlled trial investigating the effects of viewing a virtual limb upon phantom limb pain, sensation and movement. European Journal of Pain, 11, 428-436.