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Combining the Absence of Electromagnetic Fields and Mirror Therapy to Improve Outcomes for Persons with Lower-Limb Vascular Amputation

Houston, Helen MS, OTR/L; Dickerson, Anne E. PhD, OTR/L, SCDCM, FAOTA; Wu, Qiang PhD

JPO: Journal of Prosthetics and Orthotics: October 2016 - Volume 28 - Issue 4 - p 154–164
doi: 10.1097/JPO.0000000000000108
Original Research Articles

Objective The objective of this pilot study was to explore whether or not the combination of using a residual limb cover to eliminate electromagnetic fields and a mirror therapy exercise program facilitates healing and decreases pain for individuals with lower-limb vascular amputation.

Materials and Methods A cross-sectional repeated measures design compared two groups based on the time of amputation. Participants in the acute group (n = 11) began treatment within 48 hrs of their amputation, and those who had surgery at least 6 weeks before starting the study comprised the chronic group (n = 5). Effectiveness was measured by physical factors (e.g., edema, temperature) and perception of phantom limb pain (e.g., intensity, frequency, bothersomeness) at three times: pretreatment, posttreatment at 4 weeks, and maintenance after 8 weeks (interval of 4 weeks of no treatment).

Results For acute participants, edema, temperature, frequency, and bothersomeness demonstrated significant differences, whereas for the chronic group, temperature, pain intensity, frequency, and bothersomeness were significantly different. Unanticipated results were that the residual limb incisions of the individuals with acute amputations were sufficiently healed to begin prosthetic fitting a month earlier than the typical protocol—a decrease from 12 weeks to 8 weeks—and that wearing tolerance increased from 0 to 2 hrs to 8 to 12 hrs for the individuals with chronic amputations after completion of this treatment intervention.

Conclusions Results suggest that this combined treatment may improve outcomes for individuals with vascular lower-limb amputations and should be investigated further.

HELEN HOUSTON, MS OTR/L, is affiliated with Vidant Medical Center, Greenville, NC.

ANNE E. DICKERSON, PhD, OTR/L, SCDCM, FAOTA, is affiliated with East Carolina University, Greenville, NC.

QIANG WU, PhD, is affiliated with East Carolina University, Greenville, NC.

The first author received a grant from Farabloc Development Corporation in the form of the cost of the roll of Farabloc material used for the residual limb covers and the cost of the Plexiglas mirrors.

Disclosure: The authors declare no conflict of interest.

Correspondence to: Anne E. Dickerson, PhD, OTR/L, SCDCM, FAOTA, College of Allied Health Sciences, Department of Occupational Therapy, Health Sciences Building, 3305E, East Carolina University, Greenville, NC 27858; email:

© 2016 by the American Academy of Orthotists and Prosthetists.