Examining Factors of Phantom Limb Pain through Person-Centered Assessment

PROJECT SUMMARY Phantom limb pain is common after amputation, but the mechanisms and associated factors contributing to this pain remain unclear. Without an understanding of associated factors, it is difficult for clinicians to recommend effective pain treatments. The long-term goal of this research is to better understand contributing factors to phantom limb pain on an individual level to guide effective, personalized treatment approaches in the future. The overall objective of this project is to establish the feasibility and acceptability of the ecological momentary assessment (EMA) method in measuring person-centered factors contributing to phantom limb pain. EMA is a systematic survey methodology to evaluate real-time personal and environmental factors in an individual’s natural environment. The hypothesis is that EMA surveys will achieve at least 80% retention rate and 75% response rate in the amputation population. This hypothesis will be tested through two specific aims. Aim 1: Investigate factors contributing to phantom limb pain among individuals with amputations. The approach for this aim will be to conduct focus group sessions with individuals with amputations to discuss their experiences with phantom limb pain and any aggravating or relieving factors. Data from the focus groups will be used to refine a list of EMA questions on phantom limb pain contributing factors. Aim 2: Determine the feasibility and acceptability of EMA to identify phantom limb pain factors. The approach for this aim will be to use repeated EMA surveys to measure phantom limb pain and its contributing factors in individuals with amputations in real time and in their natural environment. Responses to EMA questions will be analyzed to explore factors that contribute to phantom limb pain in each participant. The feasibility and acceptability of this method in this population will be determined using recruitment rate, retention rate, response rate, and semi- structured interviews with participants. This proposed research will contribute to science through an improved understanding of contributing factors to phantom limb pain after amputation and the establishment of feasibility and acceptability of the EMA method in measuring these factors. These contributions are expected to be significant because the systematic identification of patient-specific factors will guide informed future treatment recommendations for effective, personalized medicine for phantom limb pain, addressing a critical public health need. This research is part of a comprehensive training plan that includes advanced coursework on qualitative research and causal discovery data analysis, professional development through seminars, networking, and research dissemination, and mentored training in the research skills needed to continue the applicant’s trajectory to becoming an independent researcher. The University of Minnesota’s expansive research infrastructure, the multidisciplinary doctoral program in Rehabilitation Science, and the Minneapolis Adaptive Design and Engineering laboratory create an ideal environment for completing this research and training.