Virtual Reality Treatment Displaying the Missing Leg Improves Phantom Limb Pain: A Small Clinical Trial.

Only seven participants were analyzed, and two did not complete the final limb sessions while one withdrew after the one-week follow-up, so the group results rest on a very small sample. The missing-leg VR always followed the distractor VR, and there was no washout period, so any extra benefit of the missing-leg phase cannot be separated from the earlier VR or from non-specific effects. The distractor VR also reduced pain, and the direct comparison between the two phases was not significant, so the study does not prove that seeing the missing leg is the active ingredient. Secondary battery outcomes were not corrected for multiple comparisons, so the pain interference and mood findings are exploratory. Participants continued their pain medications without change, so the results apply to adding VR to existing medication, not to medication withdrawal. Only below-knee amputees with phantom limb pain rated at least 4/10 were included, and most had long-standing pain with prior unsuccessful treatments, so the findings may not generalize to other amputees or acute pain.

No conflicts-of-interest statement is included in the article text. The publication types note NIH extramural research support.

Do not conclude that the missing-leg VR is proven better than other VR or placebo. Both the distractor and limb phases reduced pain, and the direct comparison was not significant (p=0.37).