Integrating Virtual Reality with Cognitive Behavioral Therapy to Reduce Phantom Limb Pain: Approach in Orthopedic Rehabilitation
DOI:
https://doi.org/10.65745/soj.v1.i1.12Keywords:
Phantom limb pain; VR-CBT; Orthopedic rehabilitation; Bibliometric analysisAbstract
Phantom limb pain (PLP) remains a persistent and multifaceted challenge in orthopedic rehabilitation, often resistant to conventional treatments such as pharmacotherapy and mirror therapy. This study explores the integration of Virtual Reality (VR) and Cognitive Behavioral Therapy (CBT) into a unified VR-CBT intervention as a promising and patient-centered approach to PLP management. Through a systematic literature review and bibliometric analysis of studies published between 2015 and 2025, this research evaluates both the clinical effectiveness and the evolving thematic landscape of VR-CBT applications. Findings indicate that VR-CBT can reduce pain intensity by approximately 30–50%, improve rehabilitation adherence, and address psychological factors associated with chronic pain. Bibliometric mapping further reveals a growing research trend toward interactive, immersive, and psychosocially integrated interventions, with recent emphasis on terms like “augmented reality,” “video game,” and “quality of life.” Despite these promising developments, gaps remain in protocol standardization and large-scale clinical validation. This review underscores the urgent need for rigorous, high-quality studies to establish VR-CBT as a viable and scalable solution within modern orthopedic rehabilitation.
References
Ambron E, Miller A, Kuchenbecker KJ, Buxbaum LJ, Coslett HB. (2018). Immersive Low-Cost Virtual Reality Treatment for Phantom Limb Pain: Evidence from Two Cases. Front Neurol. 9. 67. doi:10.3389/fneur.2018.00067
Annapureddy D, Annaswamy TM, Raval G, Chung YY, Prabhakaran B. (2023). A novel mixed reality system to manage phantom pain in-home: results of a pilot clinical trial. Front Pain Res (Lausanne). 4. 1183954. doi:10.3389/fpain.2023.1183954
Eldaly AS, Avila FR, Torres-Guzman RA, Maita KC, Garcia JP, Serrano LP, et al. (2024). Virtual and Augmented Reality in Management of Phantom Limb Pain: A Systematic Review. Hand (N Y). 19(4). 545-54. doi:10.1177/15589447221130093
El-Gabalawy R, Crooks M, Smith MSD, Hammond E, Gross P, Roznik M, et al. (2025). Treating Lower Phantom Limb Pain in the Postoperative Acute Care Setting Using Virtual Reality: Protocol for a 4-Phase Development and Feasibility Trial. JMIR Res Protoc. 14. e68008. doi:10.2196/68008
Elgendy MH, Helal MM, Habib AA. (2024). The influence of virtual reality approach on phantom pain in trans-tibial amputation. International Journal of Health Sciences. 8(1). https://doi.org/10.53730/ijhs.v8nS1.14796
Gan D, Wang SY, Liu K, Zhang SY, Huang H, Xing JH, et al. (2025). Innovative exploration of phantom limb pain treatment based on extended reality technology. World J Orthop. 16(6). 107422. doi:10.5312/wjo.v16.i6.107422
Hanyu-Deutmeyer AA, Cascella M, Varacallo MA. (2025) Phantom Limb Pain. StatPearls. Treasure Island (FL).
Ishigami S, Boctor C. (2024). Epidemiology and risk factors for phantom limb pain. Front Pain Res (Lausanne). 5. 1425544. doi:10.3389/fpain.2024.1425544
Lendaro E, Van der Sluis CK, Hermansson L, Bunketorp-Kall L, Burger H, Keesom E, et al. (2025). Extended reality used in the treatment of phantom limb pain: a multicenter, double-blind, randomized controlled trial. Pain. 166(3). 571-86. doi:10.1097/j.pain.0000000000003384
Limakatso K, McGowan E, Ortiz-Catalan M. (2025). Evaluating Mirror Therapy Protocols in Phantom Limb Pain Clinical Trials: A Scoping Review. J Pain Res. 18. 619-29. doi:10.2147/JPR.S502541
Makin TR, Flor H. (2020). Brain (re)organisation following amputation: Implications for phantom limb pain. Neuroimage. 218.116943. https://doi.org/10.1016/j.neuroimage.2020.116943
Mareboina M, Bastian D, Juengst SB, Annaswamy T. (2024). Insights into optimizing phantom pain management: A human-centered approach to end-user perspectives. PM R. 16(11). 1240-7. doi:10.1002/pmrj.13198
Murray CD, Pettifer S, Howard T, Patchick EL, Caillette F, Kulkarni J, et al. (2007). The treatment of phantom limb pain using immersive virtual reality: three case studies. Disabil Rehabil. 29(18). 1465-9. doi:10.1080/09638280601107385
Ortiz-Catalan M, Guethmundsdottir RA, Kristoffersen MB, Zepeda-Echavarria A, Caine-Winterberger K, Kulbacka-Ortiz K, et al. (2016). 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. 388(10062). 2885-94. doi:10.1016/S0140-6736(16)31598-7
Osumi M, Nobusako S, Zama T, Taniguchi M, Shimada S, Morioka S. (2018). Sensorimotor incongruence alters limb perception and movement. Hum Mov Sci. 57. 251-7.
Steckel BM, Schwertner R, Bücker J, Nazareth ACdP, Bizarro L, Oliveira AAd. (2024). Immersive virtual reality applied to the rehabilitation of patients with lower limb amputation: a small randomized controlled trial for feasibility study. Virtual Reality. 28(115). doi:10.1007/s10055-024-01015x
Zernitz M, Rizzello C, Rigoni M, Van de Winckel A. (2024). Case Report: Phantom limb pain relief after cognitive multisensory rehabilitation. Front Pain Res (Lausanne). 5. 1374141. doi:10.3389/fpain.2024.1374141
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