The American journal of occupational therapy : official publication of the American Occupational Therapy Association · 2026
Pain Neuroscience Education for Postamputation Pain and Functioning: Testing Embedded Education in a Mobile App for Occupational Therapy Pain Treatment.
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Rich Tonya L, Cristan Katharyn G, Marth Lindsay, Ackland Princess E
Аннотация
IMPORTANCE: Postamputation pain remains a barrier to return to function. Occupational therapy practitioners often include pain neuroscience education (PNE) to support occupational engagement and health literacy.
OBJECTIVE: To assess perspectives about PNE for postamputation pain.
DESIGN: We conducted cognitive interviews in which participants viewed PNE videos that are part of a novel graded motor imagery (GMI) mobile application for pain treatment. The videos were designed to prepare for an occupation-based rehabilitation approach. All interviews were recorded, transcribed, and analyzed using rapid-turnaround methods.
SETTING: Health care institution, telehealth format.
PARTICIPANTS: Eleven Veterans (10 males and 1 female), ages 40-75 yr, with unilateral transtibial amputation ≥1 yr, and with moderate or severe phantom limb pain, completed the study.
INTERVENTION: We developed amputation-specific PNE in the form of five recorded videos with images and minimal printed words: (1) First Steps Toward Pain Treatment, (2) Why GMI?, (3) Postamputation Pain Education, (4) Toolbox of Strategies, and (5) Your Nervous System.
OUTCOMES AND MEASURES: Cognitive interviews to measure the Veterans' perceptions of the educational content.
RESULTS: Three themes were identified: (1) Veterans are willing to try GMI but have mixed opinions on whether it is worth the effort; (2) information about postamputation pain is comforting, but perceptions of when best to receive that information differ; and (3) the educational content is understandable and relatable with respect to lived experience.
CONCLUSIONS AND RELEVANCE: PNE provides a shared understanding and can be a promising tool for occupational therapy practitioners to help Veterans manage pain. Plain-Language Summary: This study was done to test a new way of teaching Veterans with phantom limb pain following a below knee amputation. The study used videos that explained pain using mostly pictures that were part of a mobile application for pain treatment. Most Veterans in this study said they were willing to try new treatments. They found the information to be understandable and aligned with their experience of living with pain. This approach to education prepares occupational therapy clients to more actively participate in occupation-based pain treatment.
OBJECTIVE: To assess perspectives about PNE for postamputation pain.
DESIGN: We conducted cognitive interviews in which participants viewed PNE videos that are part of a novel graded motor imagery (GMI) mobile application for pain treatment. The videos were designed to prepare for an occupation-based rehabilitation approach. All interviews were recorded, transcribed, and analyzed using rapid-turnaround methods.
SETTING: Health care institution, telehealth format.
PARTICIPANTS: Eleven Veterans (10 males and 1 female), ages 40-75 yr, with unilateral transtibial amputation ≥1 yr, and with moderate or severe phantom limb pain, completed the study.
INTERVENTION: We developed amputation-specific PNE in the form of five recorded videos with images and minimal printed words: (1) First Steps Toward Pain Treatment, (2) Why GMI?, (3) Postamputation Pain Education, (4) Toolbox of Strategies, and (5) Your Nervous System.
OUTCOMES AND MEASURES: Cognitive interviews to measure the Veterans' perceptions of the educational content.
RESULTS: Three themes were identified: (1) Veterans are willing to try GMI but have mixed opinions on whether it is worth the effort; (2) information about postamputation pain is comforting, but perceptions of when best to receive that information differ; and (3) the educational content is understandable and relatable with respect to lived experience.
CONCLUSIONS AND RELEVANCE: PNE provides a shared understanding and can be a promising tool for occupational therapy practitioners to help Veterans manage pain. Plain-Language Summary: This study was done to test a new way of teaching Veterans with phantom limb pain following a below knee amputation. The study used videos that explained pain using mostly pictures that were part of a mobile application for pain treatment. Most Veterans in this study said they were willing to try new treatments. They found the information to be understandable and aligned with their experience of living with pain. This approach to education prepares occupational therapy clients to more actively participate in occupation-based pain treatment.