Phantom Motor Execution Via MPR, VR/AR, and SG, as a Treatment of PLP

NCT ID: NCT03112928

Last Updated: 2023-06-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

77 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-05-08

Study Completion Date

2021-09-20

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This international, multi-center, double-blind, randomized, controlled clinical trial aims to evaluate the efficacy of Phantom Motor Execution (PME) and Phantom Motor Imagery (PMI) as treatments of Phantom Limb Pain (PLP). In PME, myoelectric pattern recognition (MPR) is used to predict motor volition and then use the decoded movements to control virtual and augmented reality environments (VR/AR), along with serious gaming (SG). The same device and VR/AR environments are used in PMI with the difference that subjects will imagine rather than execute phantom movements. Electromyography is used to monitor for no muscular activity in PMI.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Sixty-six subjects with upper or lower limb amputations are planned to take part in this study. Subjects will be assigned randomly to PME and PMI treatments (2:1 proportion). After treatment completion (15 sessions of 2 hours each) and follow-up period of six months, patients that received PMI will be given the choice to receive PME. The design is double blinded as the patient will be informed that the treatment received, regardless of which, has been shown effective in previous studies. The person conducting the pain evaluations will be blinded to which treatment each patient receives, and will not take part on providing treatment (evaluator and therapist are different persons).

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Phantom Limb Pain

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

International, multi-centre, double-blind, randomized, controlled clinical trial
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
Participants will be informed that both treatments have been shown effective in previous studies, and in the present study we are comparing their efficacy.

The person conducting the pain evaluation (outcomes assessor) will not treat the participants and will be unaware of which treatment is given to each participant. The person treating the subject is different than the person evaluating.

The principal and coordinating investigator will receive blinded data from all participating centers to analyze the clinical trial outcomes.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Phantom Motor Execution (PME)

Phantom motor execution is decoded via myoelectric pattern recognition and promoted via serious gaming in virtual and augmented reality.

Group Type EXPERIMENTAL

Phantom Motor Execution

Intervention Type DEVICE

Neuromotus - PME decodes motor volition applying machine learning to surface electromyography. Once the intention of movement is known, this is use to control serious games in virtual and augmented reality.

A treatment session of MPE consists of:

1. Pain evaluation
2. Placement of the electrodes and fiducial marker
3. Practice of motor execution in Augmented Reality (AR)
4. Gaming using phantom movements
5. Practice of motor execution by matching random target postures of a virtual limb.

Step 3 to 4 are repeated for different phantom joints, initially one at the time progressing to several joints simultaneously. A treatment session last 2 hours.

Phantom Motor Imagery (PMI)

Use the same device and visual stimulation as PME, with the difference that participants imagine to perform, rather than execute phantom movements. Myoelectric activity is used to monitor that the subjects do not produce muscular contractions but only imagine the movements.

Group Type ACTIVE_COMPARATOR

Phantom Motor Imagery

Intervention Type DEVICE

The only difference between PME and PMI is that in the former myoelectric signals are used to give the participants control over the virtual environments, whereas in PMI the presence of myoelectric activity is used as an alarm to remind the participant that it must imagine rather than execute the phantom movement. In PMI the virtual environments act autonomously to guide the participant in imagination of movement.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Phantom Motor Execution

Neuromotus - PME decodes motor volition applying machine learning to surface electromyography. Once the intention of movement is known, this is use to control serious games in virtual and augmented reality.

A treatment session of MPE consists of:

1. Pain evaluation
2. Placement of the electrodes and fiducial marker
3. Practice of motor execution in Augmented Reality (AR)
4. Gaming using phantom movements
5. Practice of motor execution by matching random target postures of a virtual limb.

Step 3 to 4 are repeated for different phantom joints, initially one at the time progressing to several joints simultaneously. A treatment session last 2 hours.

Intervention Type DEVICE

Phantom Motor Imagery

The only difference between PME and PMI is that in the former myoelectric signals are used to give the participants control over the virtual environments, whereas in PMI the presence of myoelectric activity is used as an alarm to remind the participant that it must imagine rather than execute the phantom movement. In PMI the virtual environments act autonomously to guide the participant in imagination of movement.

Intervention Type DEVICE

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Neuromotus - PME Neuromotus - PMI

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Exclusion Criteria

* Subjects for whom skin contact or muscle contraction are painful (NRS \> 2) are not eligible for the study.
* The subject should not have any condition associated with risk of poor protocol compliance.
* The subject should not have any other condition or symptoms preventing the patient from entering the study, according to the investigator´s judgement.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Chalmers University of Technology

OTHER

Sponsor Role collaborator

Sahlgrenska University Hospital

OTHER

Sponsor Role collaborator

Örebro University, Sweden

OTHER

Sponsor Role collaborator

Bräcke Diakoni, Sweden

UNKNOWN

Sponsor Role collaborator

University Rehabilitation Institute, Republic of Slovenia

OTHER

Sponsor Role collaborator

University Medical Center Groningen

OTHER

Sponsor Role collaborator

University of New Brunswick

OTHER

Sponsor Role collaborator

National University of Ireland, Galway, Ireland

OTHER

Sponsor Role collaborator

Shirley Ryan AbilityLab

OTHER

Sponsor Role collaborator

Ruhr University of Bochum

OTHER

Sponsor Role collaborator

Integrum

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Max Ortiz Catalan, PhD

Role: PRINCIPAL_INVESTIGATOR

Chalmers Technological University

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Shirley Ryan Ability Lab

Chicago, Illinois, United States

Site Status

Institue of Biomedical Engineering, University of New Brunswick

Fredericton, New Brunswick, Canada

Site Status

Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr - University Bochum (RUB)

Bochum, , Germany

Site Status

School of Psychology, National University of Ireland

Galway, Connacht, Ireland

Site Status

University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine

Groningen, , Netherlands

Site Status

University Rehabilitation Institute

Ljubljana, , Slovenia

Site Status

Ortopedteknik, Region Örebro län

Örebro, Närke, Sweden

Site Status

Bräcke Diakoni

Stockholm, Uppland, Sweden

Site Status

Gåskolan, Ortopedtekniska avdelningen

Gothenburg, Västergötland, Sweden

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States Canada Germany Ireland Netherlands Slovenia Sweden

References

Explore related publications, articles, or registry entries linked to this study.

Ortiz-Catalan M, Guethmundsdottir RA, Kristoffersen MB, Zepeda-Echavarria A, Caine-Winterberger K, Kulbacka-Ortiz K, Widehammar C, Eriksson K, Stockselius A, Ragno C, Pihlar Z, Burger H, Hermansson L. Phantom motor execution facilitated by machine learning and augmented reality as treatment for phantom limb pain: a single group, clinical trial in patients with chronic intractable phantom limb pain. Lancet. 2016 Dec 10;388(10062):2885-2894. doi: 10.1016/S0140-6736(16)31598-7. Epub 2016 Dec 2.

Reference Type BACKGROUND
PMID: 27916234 (View on PubMed)

Ortiz-Catalan M, Sander N, Kristoffersen MB, Hakansson B, Branemark R. Treatment of phantom limb pain (PLP) based on augmented reality and gaming controlled by myoelectric pattern recognition: a case study of a chronic PLP patient. Front Neurosci. 2014 Feb 25;8:24. doi: 10.3389/fnins.2014.00024. eCollection 2014.

Reference Type BACKGROUND
PMID: 24616655 (View on PubMed)

Lendaro E, Van der Sluis CK, Hermansson L, Bunketorp-Kall L, Burger H, Keesom E, Widehammar C, Munoz-Novoa M, McGuire BE, O'Reilly P, Earley EJ, Iqbal S, Kristoffersen MB, Stockselius A, Gudmundson L, Hill W, Diers M, Turner KL, Weiss T, Ortiz-Catalan M. Extended reality used in the treatment of phantom limb pain: a multicenter, double-blind, randomized controlled trial. Pain. 2025 Mar 1;166(3):571-586. doi: 10.1097/j.pain.0000000000003384. Epub 2024 Sep 5.

Reference Type DERIVED
PMID: 39250328 (View on PubMed)

Lendaro E, Earley EJ, Ortiz-Catalan M. Statistical analysis plan for an international, double-blind, randomized controlled clinical trial on the use of phantom motor execution as a treatment for phantom limb pain. Trials. 2022 Feb 13;23(1):138. doi: 10.1186/s13063-021-05962-7.

Reference Type DERIVED
PMID: 35152915 (View on PubMed)

Lendaro E, Hermansson L, Burger H, Van der Sluis CK, McGuire BE, Pilch M, Bunketorp-Kall L, Kulbacka-Ortiz K, Rigner I, Stockselius A, Gudmundson L, Widehammar C, Hill W, Geers S, Ortiz-Catalan M. Phantom motor execution as a treatment for phantom limb pain: protocol of an international, double-blind, randomised controlled clinical trial. BMJ Open. 2018 Jul 16;8(7):e021039. doi: 10.1136/bmjopen-2017-021039.

Reference Type DERIVED
PMID: 30012784 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

007733

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Spatial-Motor Stroke-Rehab Study
NCT06053320 RECRUITING NA