Neuromotus

What is Neuromotus?

Neuromotus is a new and innovative form of therapy which allows amputees to reduce their phantom limb pain by taking control of it through augmented reality software. By using a smart electronic device with adhesive electrodes, muscle signals in the stump are captured, processed and passed through the Neuromotus software. The resulting image on the screen is that of the user’s virtual limb, which they can then visualise and move in real-time. Controlling these images can be made progressively more challenging with the use of interactive games and other challenges.  This technology has shown a significant reduction of phantom limb pain in patients for whom no other treatment has worked previously.  Clinical trials are demonstrating a 50% pain reduction, 50% less intrusion of phantom limb pain during sleeping and a 50% reduction in pain management medication. Studies continue to show that this improvement is maintained at six months.

Who can use Neuromotus?

Neuromotus is suitable for amputees with phantom limb pain who have some muscle activity in their stump. Unlike mirror therapy, an intact remaining limb is not necessary. Because the electrodes need to be able to read muscle signals, it may be difficult to record from stumps with significant scarring. We can advise whether this is likely to be a problem beforehand. 

There have not been incidences in the research trials of worsening symptoms for this group of amputees; although it does not work for everyone in terms of pain reduction, it is important to note that the clinical trials report an average of 50% pain reduction. There will be users who gain more benefit from this, and users who do not.  Clinical trials provided Neuromotus therapy for 12 sessions, each of two hours duration to achieve their results of 50% reduction in pain symptoms. Ideally, sessions would be on a weekly basis, so it is important to be able to commit to this length of treatment. 

References

  • Ortiz-Catalan M, Guð*mundsdóttir RA, Kristoffersen MB, Zepeda-Echavarria A, Caine-Winterberger K, Kulbacka-Ortiz K, et al. . Phantom motor execution facilitated by machine learning and augmented reality as treatment for phantom limb pain: a single group, clinical trial in patients with chronic intractable phantom limb pain. Lancet (2016) 388:2885–94. 10.1016/S0140-6736(16)31598-7
  • Lendaro, E., Hermansson, L., Burger, H., van der Sluis, C. K., McGuire, B. E., Pilch, M., … Ortiz-Catalan, M. (2018). Phantom motor execution as a treatment for phantom limb pain?: protocol of an international, double-blind, randomised controlled clinical trial. BMJ Open, 8(7). https://doi.org/10.1136/bmjopen-2017-021039 
  • Ortiz-Catalan M. (2018). The Stochastic Entanglement and Phantom Motor Execution Hypotheses: A Theoretical Framework for the Origin and Treatment of Phantom Limb Pain. Frontiers in neurology, 9, 748. doi:10.3389/fneur.2018.00748