Last updated 2024-06-13T18:24:48Z

Mixed Reality to Manage Phantom Pain (Mr. MAPP)

Mr.MAPP is a mixed reality system that combines VR and computer vision technologies in a novel technology application. Mr.MAPP employs off-the-shelf RGB-D cameras such as Microsoft Kinect to capture and generate a 3D model of the person in real-time. An illusion of the virtual limb is crafted by mirroring the patient's preserved limb in the captured data using computer vision and graphics techniques. Mr.MAPP framework has successfully solved the following problems: a) capturing live 3D models of individuals, b) generating the 3D model of the missing limb in real-time, c) generating corresponding mirror movement in real-time, and d) rendering the 3D model of the person along with the simulated missing limb for an immersive and interactive experience. Also, to make the therapy sessions more engaging, fun and non-monotonous, we designed an attractive virtual environment and games with engaging tasks.

Origin:

January 2020, Dallas VA Medical Center

Adoptions:

1 in-progress

Partners:

Health Services Research & Development, XR Network

Overview

Problem

After major neuromusculoskeletal trauma or vascular ischemia that results in an amputation, patients commonly experience residual sensation in their missing limb that is referred to as phantom limb. Such patients frequently develop a painful sensation in their missing limb defined as phantom limb pain (PLP). PLP is chronic pain that can be a very distressing ... After major neuromusculoskeletal trauma or vascular ischemia that results in an amputation, patients commonly experience residual sensation in their missing limb that is referred to as phantom limb. Such patients frequently develop a painful sensation in their missing limb defined as phantom limb pain (PLP). PLP is chronic pain that can be a very distressing consequence of acquired limb loss. PLP is a serious cause of severe distress and physical limitations in up to 85% of amputees. Restriction in normal activities and higher levels of depression often severely affects the patient's social and work life. Although various surgical, psychological and pharmacological treatment modalities have been used to treat PLP, their effectiveness is often limited and short-term. See more

Solution

The primary goals of this pilot project are to evaluate the feasibility and preliminary functional outcomes of this system in a sample of Veterans with lower limb amputation. Findings from this single-arm pilot study will serve as preliminary data to inform future fully powered clinical trials to assess Mr.MAPP’s efficacy in treating PLP and practical clinic ... The primary goals of this pilot project are to evaluate the feasibility and preliminary functional outcomes of this system in a sample of Veterans with lower limb amputation. Findings from this single-arm pilot study will serve as preliminary data to inform future fully powered clinical trials to assess Mr.MAPP’s efficacy in treating PLP and practical clinical implementation of these findings in real-world settings.
Aim 1: Assess the feasibility and acceptance of using Mr.MAPP as a home-based exercise therapy intervention to manage PLP in a pilot sample of Veterans with lower limb amputation.
Aim 2: Evaluate pain and functional outcomes in 10 Veterans with lower limb amputation and PLP, after using Mr.MAPP for 1-month. See more

Results

This is an ongoing pilot study.

Files

Pre-Print publication of Pilot study MedRx Manuscript

Metrics

We are evaluating outcomes using the following outcome measures: 1) McGill Pain Questionnaire (MPQ) scores and 2) Brief Pain Inventory (BPI) scores. Functional outcome variables: Patient specific functional scale (PSFS) on which goal attainment on a pre-identified set of 3 functional goals is assessed on a 0-10 scale. Secondary outcomes: 1) Medication use: We will monitor and evaluate medication use for pain control (to include acetaminophen, topical therapies, non-steroidal anti-inflammatory medications and opioids) to evaluate if improvement in outcomes is associated with any corresponding decrease in use of pain alleviating medications, 2) System use and exercise adherence information will be evaluated using real-time digital data recorded on the system including number of repetitions, dates and times of exercises, as well as game performance data.

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)

There are no successful adoptions for this innovation.

TX: Dallas VA Medical Center (Dallas)

Started adoption on 01/2020.

There are no unsuccessful adoptions for this innovation.

Multimedia

Images

Schematic illustration of Mr.MAPP use in treating phantom pain

Implementation

Timeline

1-2 years

Anticipated Timelines and Milestones

Completion of ongoing clinical pilot research trial-Anticipated Oct 2021

Acquiring MR.MAPP software and XR hardware: 6-m to 1-year (Pending licensing and patent application)

Learning and training on clinical implementation of treatment protocol: 1-year

Departments

Physical medicine and rehabilitation

Contact

Comment

Comments and replies are disabled for retired innovations and non-VA users.

Email

Email NTXPolytraumaBuilding@va.gov with questions about this innovation.

About

Origin story

This practice emerged out of conversations and collaborations between the PM&R Service at the Dallas VA Medical Center and the Computer Science department at University of Texas at Dallas.

Original team

Gargi Raval, MD

Amputee Clinic director

Balakrishnan Prabhakaran, PhD

Professor in Computer Science

Elonm (Manuella) Gbedey

Research Study Coordinator

Yu-Yen Chung

Graduate Student Researcher

Thiru Annaswamy, MD

Clinical Lead and Principal Investigator

Search tags

Extended Reality (XR) Home Health Outpatient Care Specialty Care VA Immersive Veteran Experience

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