Effects of Phantom Exercises on Pain, Mobility, and Quality of Life among Lower Limb Amputees: A Prospective Observational Study

Abstract

Background: Many people who undergo lower limb amputation will experience Phantom Limb Pain that is, they constantly feel pain in the leg that has already been amputated and no longer exists. This condition is a very common post-amputation complication, which not only impedes patients' walking and daily activities, but also drags down their overall Quality of Life. Currently, the common clinical response measures are Mirror Therapy and conventional physical therapy, both of which have been widely adopted. However, the role of specialized phantom limb exercises in post-amputation rehabilitation has not been thoroughly studied by the academic community to date.Methods: We conducted a prospective observational study, which enrolled a total of 24 patients with unilateral Lower Limb Amputee. Among these patients, some had amputation sites above the knee, and some below the knee, covering both categories. All patients received a combined rehabilitation program that simultaneously applied the aforementioned Mirror Therapy, conventional physical therapy, and the under-studied phantom limb exercises. To track the effects of this rehabilitation program, we selected three fixed time points to conduct assessments for the patients: the first was before the start of rehabilitation, that is, before receiving any treatment; the second was at the 2-week mark of rehabilitation; the third was at the 4-week mark of rehabilitation. Each assessment measured three core items: pain intensity was measured using the Visual Analogue Scale (VAS), mobility was measured using the Amputee Mobility Predictor (AMP), and Quality of Life was measured using the RAND SF-36 scale.Results: Pain scores decreased significantly over 4 weeks (VAS baseline 4.4 ± 1.5 to 2.2 ± 0.6, p < 0.01). The bodily pain domain of SF‑36 improved markedly (baseline 56.4 ± 15.5 to 72.9 ± 16.2, p = 0.012). Mobility scores improved beyond the minimal detectable change (AMP baseline 20.8 ± 3.6 to 25.9 ± 4.1).Conclusion: Combining phantom limb exercises with Mirror Therapy and physical therapy, when applied to the amputee population, can significantly alleviate their chronic Phantom Limb Pain, and also improve patients' self-assessed Quality of Life. The findings of this study support the integration of this combined program into the standard rehabilitation procedures for Lower Limb Amputee patients. However, to confirm the direct causal relationship between these rehabilitation measures and reduced pain as well as improved Quality of Life, dedicated controlled trials still need to be carried out.