Digital Mirrors: Virtual and Augmented Reality for Phantom Limb Pain
DOI :
https://doi.org/10.25759/spmfr.562Mots-clés :
Phantom Limb, Virtual Reality, AmputeesRésumé
Introduction: Phantom limb pain (PLP) affects 50 - 85 % of individuals following amputation and remains refractory to many conventional therapies. Virtual reality (VR) and augmented reality (AR)- based interventions have emerged as promising alternatives by engaging sensorimotor cortical circuits and providing enriched visual feedback. This systematic review evaluates current evidence on the efficacy of VR/AR treatments for PLP in post- amputation populations.
Methods: We searched PubMed and Scopus databases for studies that evaluated nonimmersive or immersive VR/AR therapies in adults with PLP. The research was performed in January 2025, and seventeen studies (five randomized controlled trials and twelve prospective studies) met inclusion criteria. Data on intervention type, control modality, pain outcomes and secondary measures (quality of life, usability) were extracted and synthesized.
Results: Among 17 studies, six used non- immersive VR/AR, while eleven applied immersive systems. Various VR/AR implementations were used, including creation of a virtual limb from a mirror image of an intact limb, control of a virtual limb via electromagnetic sensors, creation of a braincomputer interface, and use of a tablet- based virtual treatment. All the non- immersive AR/VR interventions yielded reductions in phantom- limb pain intensity, irrespective of the specific technology or delivery format. Eleven studies reported decreased PLP after AR/VR immersive treatments, of which seven reported significant reductions. The studies documented uniformly high ratings of realism, immersion, and overall satisfaction with the VR/AR experience.
Discussion: The strongest evidence for clinically relevant PLP relief (≥ 30 % pain reduction) comes from EMG- driven phantom- motor execution and fully immersive VR protocols. Mirror- style VR and tablet- based AR yield smaller but still positive effects. Methodological heterogeneity across studies- treatment dose, outcome instruments, follow- up duration- precludes direct comparisons. The decreasing cost of head- mounted displays (HMDs) is lowering barriers to clinical adoption.
Conclusion: VR/AR- based therapies can produce meaningful analgesia for PLP, particularly when they combine active motor execution, multisensory feedback, and immersive environments. Future large- scale RCTs with standardized protocols and direct comparisons between nonimmersive and immersive formats are needed to optimize treatment strategies.
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