Murray Amputation, Prosthesis Use, and Phantom Limb Pain

An Interdisciplinary Perspective
1. Auflage 2009
ISBN: 978-0-387-87462-3
Verlag: Springer-Verlag
Format: PDF
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 203 Seiten

The main objective in the rehabilitation of people following amputation is to restore or improve their functioning, which includes their return to work. Full-time employment leads to beneficial health effects and being healthy leads to increased chances of full-time employment (Ross and Mirowskay 1995). Employment of disabled people enhances their self-esteem and reduces social isolation (Dougherty 1999). The importance of returning to work for people following amputation the- fore has to be considered. Perhaps the first article about reemployment and problems people may have at work after amputation was published in 1955 (Boynton 1955). In later years, there have been sporadic studies on this topic. Greater interest and more studies about returning to work and problems people have at work following amputation arose in the 1990s and has continued in recent years (Burger and Marinc ?ek 2007). These studies were conducted in different countries on all the five continents, the greatest number being carried out in Europe, mainly in the Netherlands and the UK (Burger and Marinc ?ek 2007). Owing to the different functions of our lower and upper limbs, people with lower limb amputations have different activity limitations and participation restrictions compared to people with upper limb amputations. Both have problems with driving and carrying objects. People with lower limb amputations also have problems standing, walking, running, kicking, turning and stamping, whereas people with upper limb amputations have problems grasping, lifting, pushing, pulling, writing, typing, and pounding (Giridhar et al. 2001).

Autoren/Hrsg.

Murray, Craig

Inhaltsverzeichnis

1;Contents;5
2;Contributors;7
3;Chapter 1;10
3.1;Developing an Interdisciplinary Perspective on Amputation, Prosthesis Use, and Phantom Limb Pain: An Introduction;10
4;Chapter 2;15
4.1;Need-Directed Design of Prostheses and Enabling Resources;15
4.1.1;2.1 .Introduction;15
4.1.2;2.2 .Prosthesis Acceptance: A Question of Need;16
4.1.3;2.3 .Prosthetic Technology: Need-Directed Design;20
4.1.3.1;2.3.1 .Consumer Design Priorities;20
4.1.3.1.1;2.3.1.1 .Design for Comfort;20
4.1.3.1.2;2.3.1.2 .Design for Cost;21
4.1.3.1.3;2.3.1.3 .Design for Anthropomorphism;22
4.1.3.1.4;2.3.1.4 .Design for Sensation;22
4.1.3.2;2.3.2 .Design for Function;23
4.1.4;2.4 .Enabling Resources: Meeting Needs;23
4.1.4.1;2.4.1 .Healthcare Services;23
4.1.4.2;2.4.2 .Social Support Mechanisms;25
4.1.5;2.5 .Concluding Remarks;26
4.2;References;27
5;Chapter 3;30
5.1;Ethical and Medico-Legal Issues in Amputee Prosthetic Rehabilitation;30
5.1.1;3.1 .Introduction;30
5.1.2;3.2 .Attitudes Pertaining to Autonomy: Consent;32
5.1.3;3.3 .Non-malefience;34
5.1.4;3.4 .Justice: Resource Allocation and Distributive Costs;34
5.1.5;3.5 .Rationing;35
5.1.6;3.6 .Best Interest Principle: High-Tech or Low-Tech;36
5.1.7;3.7 .Withdrawal of Prostheses;37
5.1.8;3.8 .Concluding Comments;38
5.2;References;38
6;Chapter 4;39
6.1;Monitoring of Upper Limb Prosthesis Activity in Trans-Radial Amputees;39
6.1.1;4.1 .Upper Limb Prostheses: Background;40
6.1.2;4.2 .Justification for the Study;41
6.1.3;4.3 .Upper Limb Prostheses and Their Evaluation;42
6.1.3.1;4.3.1 .Introduction;42
6.1.3.2;4.3.2 .Current Approaches to Prosthesis Evaluation;43
6.1.3.2.1;4.3.2.1 .Questionnaires, Interviews and Clinical Records;43
6.1.3.2.2;4.3.2.2 .Direct-Observation Based Functionality Tests;44
6.1.3.2.3;4.3.2.3 .Conclusion;44
6.1.3.3;4.3.3 .Activity Monitoring;45
6.1.3.3.1;4.3.3.1 .Background;45
6.1.3.3.2;4.3.3.2 .Sensor Technologies;45
6.1.3.3.3;4.3.3.3 .Lower Limb and Whole Body Activity Monitors;45
6.1.3.3.4;4.3.3.4 .Upper Limb Activity Monitors;46
6.1.3.4;4.3.4 .Activity Monitoring and Upper Limb Prosthesis Evaluation;47
6.1.4;4.4 .Methods;49
6.1.4.1;4.4.1 .Introduction;49
6.1.4.1.1;4.4.1.1 .Tasks and Objects Used in the Evaluation Study;50
6.1.4.1.2;4.4.1.2 .Final Experimental Design;51
6.1.4.1.3;4.4.1.3 .Calculating Acceleration from Marker Data;52
6.1.4.1.4;4.4.1.4 .Subjects;53
6.1.4.1.5;4.4.1.5 .Data Collection;54
6.1.4.1.6;4.4.1.6 .Data Structure and Segmentation;54
6.1.4.1.7;4.4.1.7 .Activity Classification;55
6.1.5;4.5 .Results;58
6.1.5.1;4.5.1 .Subjects and Data;58
6.1.5.2;4.5.2 .The Neural Network and Task Classification;60
6.1.6;4.6 .Discussion and Conclusions;62
6.1.6.1;4.6.1 .Discussion;62
6.1.6.1.1;4.6.1.1 .Subject-Specific or Generalised Neural Network?;62
6.1.6.1.2;4.6.1.2 .Between Day Performance;64
6.1.6.1.3;4.6.1.3 .Data from Single or Multiple Locations on the Body?;64
6.1.6.1.4;4.6.1.4 .Functional vs. Non-functional Tasks;64
6.1.6.2;4.6.2 .Future Work;65
6.1.7;4.7 .Conclusion;66
6.2;References;66
7;Chapter 5;70
7.1;Adaptation to Amputation and Prosthesis Use;70
7.1.1;5.1 .Introduction;70
7.1.2;5.2 .Adaptation;71
7.1.2.1;5.2.1 .Emotional Well-being;73
7.1.2.2;5.2.2 .Body Image, Stigma and Social Discomfort;74
7.1.2.3;5.2.3 .Summary;76
7.1.3;5.3 .Psychosocial Factors Impacting on Adaptation;76
7.1.3.1;5.3.1 .Coping;77
7.1.3.2;5.3.2 .Social Support;78
7.1.4;5.4 .Cultural Factors;80
7.1.5;5.5 .Importance for Health Service Providers;81
7.1.6;5.6 .Conclusion;82
7.2;References;82
8;Chapter 6;85
8.1;Understanding Adjustment and Coping to Limb Loss and Absence through Phenomenologies of Prosthesis Use;85
8.1.1;6.1 .Introduction;85
8.1.2;6.2 .Study Background;87
8.1.3;6.3 .Embodied Experience;88
8.1.4;6.4 .Personal Meanings;91
8.1.5;6.5 .Social Meanings;94
8.1.6;6.6 .General Discussion;97
8.1.6.1;6.6.1 .Embodied Experience;97
8.1.6.2;6.6.2 .Personal Meanings;98
8.1.6.3;6.6.3 .Social Meanings;101
8.1.7;6.7 .Conclusion;102
8.2;References;102
9;Chapter 7;104
9.1;Return to Work After Amputation;104
9.1.1;7.1 .Introduction;105
9.1.2;7.2 .Lower Limb Amputation and Work;105
9.1.2.1;7.2.1 .Successful Return to Work;105
9.1.2.2;7.2.2 .Type of Work;106
9.1.2.3;7.2.3 .Time of Return to Work;107
9.1.2.4;7.2.4 .Factors Influencing Return to Work;107
9.1.2.4.1;7.2.4.1 .General Factors;107
9.1.2.4.2;7.2.4.2 .Factors Related to Impairments and Disabilities Due to Amputation;108
9.1.2.4.3;7.2.4.3 .Rehabilitation;109
9.1.2.4.4;7.2.4.4 .Prosthesis;109
9.1.2.4.5;7.2.4.5 .Work and Policies Related Factors;109
9.1.3;7.3 .Upper Limb Amputation and Work;111
9.1.3.1;7.3.1 .Successful Return to Work;111
9.1.3.2;7.3.2 .Type of Work;111
9.1.3.3;7.3.3 .Time to Return to Work;112
9.1.3.4;7.3.4 .Factors Influencing Return to Work;112
9.1.3.4.1;7.3.4.1 .General Factors;112
9.1.3.4.2;7.3.4.2 .Factors Related to Impairments and Disabilities Due to Amputation;113
9.1.3.4.3;7.3.4.3 .Rehabilitation;113
9.1.3.4.4;7.3.4.4 .Prosthesis;113
9.1.3.4.5;7.3.4.5 .Work and Policies-Related Factors;114
9.1.4;7.4 .Conclusion;114
9.2;References;115
10;Chapter 8;118
10.1;Gender, Sexuality and Prosthesis Use: Implications for Rehabilitation;118
10.1.1;8.1 .Introduction;118
10.1.2;8.2 .A Qualitative Exploration of Gender, Sexuality and Prosthesis Use: Study Background;122
10.1.2.1;8.2.1 .Data Examples of Gendered Concerns, Sexuality, Romantic Relationships and Prosthesis Use;122
10.1.2.1.1;8.2.1.1 .The Prosthesis and Gendered Identities;123
10.1.2.1.2;8.2.1.2 .Barriers and Facilitators to Forming Romantic and Sexual Relationships;125
10.1.3;8.3 .Discussion;128
10.2;References;129
11;Chapter 9;131
11.1;Post Amputation Chronic Pain Profile and Management;131
11.1.1;9.1 .Introduction;131
11.1.1.1;9.1.1 .Acute Post-Operative Pain;132
11.1.1.2;9.1.2 .Nociceptive Pain in the Stump;132
11.1.1.3;9.1.3 .Neuropathic Pain of the Stump;132
11.1.1.4;9.1.4 .Phantom Limb Pain;133
11.1.2;9.2 .Treatment and Management;134
11.1.2.1;9.2.1 .Acute Post-Operative Pain;134
11.1.2.2;9.2.2 .Management of Nociceptive Stump Pain;134
11.1.2.3;9.2.3 .Management of Neuropathic Stump Pain and Phantom Pain;135
11.1.2.3.1;9.2.3.1 .Non-Pharmacological Interventions;135
11.1.2.3.2;9.2.3.2 .Pharmacological Treatment;135
11.1.2.3.3;9.2.3.3 .Antidepressants;135
11.1.2.3.4;9.2.3.4 .Anticonvulsants;135
11.1.2.3.5;9.2.3.5 .Other Drugs;136
11.1.2.3.6;9.2.3.6 .Local Creams;136
11.1.2.3.7;9.2.3.7 .Injection Treatments;136
11.1.2.3.8;9.2.3.8 .Neurostimulation;137
11.1.2.3.9;9.2.3.9 .Low Back Pain;137
11.1.2.3.10;9.2.3.10 .Proximal Joint Arthritis Related Pain;137
11.1.3;9.3 .Conclusion;137
11.2;References;138
12;Chapter 10;139
12.1;Phantom Limb Pain; Prevalence, Mechanisms and Associated Factors;139
12.1.1;10.1 .Background;139
12.1.1.1;10.1.1 .Phantom Phenomena in Amputated Limbs;140
12.1.1.2;10.1.2 .Phantom Limb Pain;141
12.1.1.2.1;10.1.2.1 .Description and Intensity of PLP;142
12.1.1.2.2;10.1.2.2 .Temporal Elements of PLP;143
12.1.1.2.3;10.1.2.3 .Mechanism for PLP;143
12.1.1.2.3.1;10.1.2.3.1 .Peripheral Nerve Involvement;143
12.1.1.2.3.2;10.1.2.3.2 .Evidence of Spinal Cord Involvement;144
12.1.1.2.3.3;10.1.2.3.3 .The Brain/Higher Centres;144
12.1.1.2.4;10.1.2.4 .Pain/Neuronal Memory and PLP;146
12.1.1.2.5;10.1.2.5 .The Neuromatrix Theory;147
12.1.1.2.6;10.1.2.6 .Treatment of PLP;148
12.1.1.2.6.1;10.1.2.6.1 .Pre-Emptive Treatment for PLP;148
12.1.1.2.6.1.1;10.1.2.6.1.1 .Evidence in Support of Pre-Emption;148
12.1.1.2.6.1.2;10.1.2.6.1.2 .Evidence Against Pre-Emption;149
12.1.1.2.6.1.3;10.1.2.6.1.3 .Pre-Emption – A Summary;150
12.1.1.2.7;10.1.2.7 .Factors Associated with PLP;150
12.1.1.2.7.1;10.1.2.7.1 .Psychosociocultural Factors;151
12.2;References;153
13;Chapter 11;159
13.1;Management of Phantom Limb Pain;159
13.1.1;11.1 .Introduction;159
13.1.2;11.2 .Pain Assessment;160
13.1.3;11.3 .Pharmacological Management of PLP;161
13.1.4;11.4 .The World Health Organisation Analgesic Ladder;161
13.1.5;11.5 .Antidepressant Therapy;162
13.1.5.1;11.5.1 .Side-Effects;162
13.1.5.1.1;11.5.1.1 .Tricyclics;162
13.1.5.1.2;11.5.1.2 .SSRIs;163
13.1.5.1.3;11.5.1.3 .SSNRIs;163
13.1.5.2;11.5.2 .Advice to Patients;163
13.1.6;11.6 .Anticonvulsant Therapy;163
13.1.6.1;11.6.1 .Side-Effects;164
13.1.6.2;11.6.2 .Advice to Patients;164
13.1.7;11.7 .Other Drugs;164
13.1.8;11.8 .Conclusion of Pharmacological Therapies;164
13.1.9;11.9 .Non-Pharmacological Therapy for PLP;165
13.1.9.1;11.9.1 .Neuromodulation;165
13.1.9.1.1;11.9.1.1 .Peripheral Stimulation – Transcutaneous Electrical Nerve Stimulation;165
13.1.9.1.2;11.9.1.2 .Central Stimulation;165
13.1.9.1.3;11.9.1.3 .Spinal Cord Stimulation (SCS);165
13.1.9.1.4;11.9.1.4 .Deep Brain Stimulation;166
13.1.10;11.10 .Psychological Factors Affecting Phantom Limb Pain;166
13.1.11;11.11 .Psychological and Cognitive Interventions for PLP;168
13.1.11.1;11.11.1 .Cortical Reorganisation and PLP;168
13.1.11.2;11.11.2 .Imagined and Virtual Visuo-Motor Feedback for Chronic Pain;169
13.1.11.3;11.11.3 .PLP Treatment Plan;171
13.2;References;172
14;Chapter 12;176
14.1;Virtual Solutions to Phantom Problems: Using Immersive Virtual Reality to Treat Phantom Limb Pain;176
14.1.1;12.1 .Introduction;176
14.1.2;12.2 .Augmented Virtual Reality: The Dublin Psychoprosthetics Group;180
14.1.2.1;12.2.1 .Empirical Work with the Augmented Mirror Box;181
14.1.3;12.3 .Virtual Agency: Cole and Colleagues;183
14.1.3.1;12.3.1 .Empirical Work with the Virtual Agency System;183
14.1.4;12.4 .Immersive Virtual Reality: Murray and Colleagues;185
14.1.4.1;12.4.1 .Empirical Work with the Immersive Virtual Reality System;187
14.1.5;12.5 .Summary and Discussion;193
14.2;References;196
15;Index;198