Effectivity of Motor Imagery and MirrorTherapy in Amputees

Study Overview
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Brief Summary
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This study evaluates the effectiveness of imagery motor on phantom pain and amputation process

Detailed Description
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The expected increase in the number of amputations in the coming decades requires special attention to the common effect after called phantom limb amputation. That term refers to the phenomena covering the sensations that occur in the affected limb and whose prevalence rate is an important part of amputees subjects. Developed theories about their origin focus their attention on the central nervous system and the peripheral nervous system. Thus, the imaginary movement is a complex cognitive, sensory and proprioceptive process leading to a mental representation of movement and it is a widely used technique in neurological rehabilitation and complex pain syndrome.

Official Title
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Effectivity of Differences Therapies on Central Nerve System for Pain, Phantom, Disability and Quality of Life in Amputees

Conditions
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Amputees

Intervention / Treatment
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* Other: Treatment Traditional and Imaginary Motor Program
* Other: Treatment Traditional and Mirror Therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pain in the stump area ≥ 3 months, no intermittent Have three months elapsed amputation, Submit subjective sensation of phantom limb not blinking Exclusion Criteria: Clinical signs of radiculopathy. Lumbar stenosis, fibromyalgia, spondylolisthesis. History of spinal surgery. Corticosteroid therapy in the past two weeks. Disease of the central nervous system or peripheral.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Treatment Traditional and Motor Imaginary Program<br>Amputees patients also conservative protocol will undergo physiotherapy techniques work Motor Imaginary Program, based on a system of two videos that allow the patient to recreate the normal way. The first video will include two sequences of a harmonic gear that will allow the patient to examine, with the physiotherapist, the characteristics of the different body segments involved in locomotion and place the member in space. The second video include an analysis in five phases. This protocol will be applied 3 days a week (25-30minutos) for one month. | Other: Treatment Traditional and Imaginary Motor Program<br>* Amputees patients also conservative protocol will undergo physiotherapy techniques work Imaginary Motor. The first video will include two sequences of a harmonic gear that will allow the patient to examine, with the physiotherapist, the characteristics of the different body segments involved in locomotion and place the member in space. The second video include an analysis in five phases: a) relaxation of Benson, b) phase external imagination where cycles of normal running on a video provided by the physiotherapist, c) phase internal imagination where the patient will identify the problem discussed compared with the normal course presented in the video, d) recreation of images in the first person made an e normalized locomotion) closing his eyes, prompted the patient to mentally recreate sequences normal gait and analyzed and subsequently verbalize differences of these with respect to their own way of getting around.<br>|
| Active Comparator: Treatment Traditional and Mirror Therapy<br>Amputees patients also conservative protocol will undergo physical therapy techniques mirror therapy work. The protocol will consist of mirror therapy sessions three days a week (25-30 minutes) for a month, where participants will move the intact limb looking in the mirror and imagining the movement of the limb with phantom sensation. | Other: Treatment Traditional and Mirror Therapy<br>* Amputees patients also conservative protocol will undergo physiotherapy techniques mirror therapy work. The protocol will consist of mirror therapy sessions three days a week (25-30 minutes) for a month, where participants will move the intact limb looking in the mirror and imagining the movement of the limb with phantom sensation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numerical Rating Scale (NRS) |  | Changes from Baseline Numerical Rating Scale at one month. Changes from Baseline Numerical Rating Scale at three months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| McGiII Pain Questionnaire (MPQ) |  | Changes from Baseline McGiII Pain Questionnaire at one month. Changes from Baseline McGiII Pain Questionnaire at three months | 
| The Vividness of Visual Imagery Questionnaire |  | Changes from Baseline Vividness of Visual Imagery Questionnaire at one month and three months | 
| Beck Depression Inventory |  | Changes from Baseline Beck Depression Inventory at one month. Changes from Baseline Beck Depression Inventory at three months | 
| Neuropathic Pain Questionnaire (DN4) |  | Changes from Baseline Neuropathic Pain Questionnaire at one month. Changes from Baseline Neuropathic Pain Questionnaire at three months | 
| Pressure Algometer (kg/cm2) | Pressure algometer in lumbar pain, amputated limb and health limb | Changes from Baseline Pressure Algometer at one month. Changes from Baseline Pressure Algometer at three months | 
| West-Haven-Yale Multidimensional Pain Inventory |  | Changes from Baseline West-Haven-Yale Multidimensional Pain Inventory at one month. Changes from Baseline West-Haven-Yale Multidimensional Pain Inventory at three months | 
| The Barthel Index of ADLs |  | Changes from Baseline Barthel Index of ADLs at one month. Changes from Baseline Barthel Index of ADLs at three months | 
| Instrumental Activities of Daily Living Scale (IADL) |  | Changes from Baseline Instrumental Activities of Daily Living Scale at one month. Changes from Baseline Instrumental Activities of Daily Living Scale at three months | 
| The Functional Independence Measure Scale (FIM) |  | Changes from Baseline Functional Independence Measure Scale at one month. Changes from Baseline Functional Independence Measure Scale at three months | 
| Quality of Life Questionnaire scoring (SF36) |  | Changes from Baseline Quality of Life Questionnaire Scoring at one month. Changes from Baseline Quality of Life Questionnaire Scoring at three months | 
| Multidimensional Body Self Relations Questionnaire (MBSRQ) |  | Changes from Baseline Multidimensional Body Self Relations Questionnaire at one month. Changes from Baseline Multidimensional Body Self Relations Questionnaire at three months | 
| Tampa Scale for Kinesiophobia (TSK) |  | Changes from Baseline Tampa Scale for Kinesiophobia at one month. Changes from Baseline Tampa Scale for Kinesiophobia at three months | 
| Pain Catastrophizing Scale (PCS) |  | Changes from Baseline Pain Catastrophizing Scale at one month. Changes from Baseline Pain Catastrophizing Scale at three months | 
| Pain Management Inventory |  | Changes from Baseline Pain Management Inventory at one month. Changes from Baseline Pain Management Inventory at three months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Motor control Laterality, Pain Perception, Lower Extremity, Complementary Therapies, Physical Therapy Modalities