Preventing Chronic Phantom Limb Pain Using Mirror Therapy and Transcranial Direct Current Stimulation Applied Early After Limb Amputation

What this Trial Is About

This research aims to prevent the long-term development of phantom limb pain PLP in adults who have recently undergone limb amputation. Most amputees experience PLP, which can be severe and last for years. The study focuses on how combined neuromodulatory treatments using mirror therapy MT and transcranial direct current stimulation tDCS applied during the early acute phase of PLP might prevent chronic pain and improve related symptoms like phantom sensations, negative feelings, and body awareness. Participants will be randomly assigned to one of three groups no intervention natural course, MT with sham tDCS, or MT with real tDCS. Both MT and tDCS are self-administered through 20 daily sessions excluding weekends over four weeks, lasting 20 minutes each. The first two sessions occur in a clinic to train participants and caregivers, after which treatments can be done at home or in the clinic. The tDCS device is specially designed for home use and supports double-blind administration. Throughout the study, participants will continue their usual rehabilitation care, including physical therapy and medication. Data on pain intensity and other clinical and behavioral measures will be collected at five time points, focusing on pain levels four weeks after completing the interventions. Researchers will also assess body ownership, anxiety, depression, pain qualities, frequency of pain episodes, and other sensations related to amputation. The study will run until March 2029 and involves careful monitoring to evaluate the effectiveness of these combined treatments in preventing chronic PLP.

Preventing Chronification of Phantom Limb Pain Through Mirror Therapy in Conjunction With tDCS