Showing posts with label amputee. Show all posts
Showing posts with label amputee. Show all posts

Sunday, December 4, 2016

END THE PAIN PROJECT MIRROR THERAPY WORKSHOPS EXPAND TO SIERRA LEONE

Jean Luc Ngambre training Mondeh Abdulaziz
Cutting off peoples’ limbs, in most cases their hands, was one of the brutal strategies used by members of the Revolutionary United Front to terrify people to support them during the 1991-2002 civil war in Sierra Leone. 

Some 27,000 Sierra Leoneans are estimated to have been disabled or have had one or more limbs amputated during that time. Many of these amputees still suffer phantom limb pain years after the war.

End The Pain Project addresses this lingering problem with the training of Mondeh Abdulaziz on November 19-20, 2016 by ETPP Senior Trainer Jean Luc Ngambre in Burera District, Rwanda. 




 Mondeh Abdulaziz, Mirror Therapy Practitioner

Mr. Abdulaziz received certification as an ETPP Mirror Therapy Practitioner on December 5, 2016 and will offer the effective pain-eliminating therapy at peer-to-peer workshops for amputees  in Sierra Leone upon his return.

Sierra Leone now joins Rwanda as part of ETPP Pan-Africa headed by Jean Luc Ngambre.


Saturday, October 17, 2015

Mirror Therapy Adria Holds Successful Mirror Therapy Workshop in Fojnica


From left to right (standing) as Emira Klisura-Bosnia, Samra Karač-Bosnia, Antonela Pavić-Croatia, Tarik Žetica-Bosnia, Matej Bedenik-Slovenia, Edis Kozić-Bosnia; (seated) Jasmin Avdović-Mirror therapy Adria MT trainer, Nikola Dobrijević-Croatia

On October 17, 2015, Mirror Therapy Adria organized a Mirror Therapy Workshop for Physical Therapy Practitioners in the central Bosnian town of Fojnica. The town is well known for the biggest thermal and rehabilitation spa center in Bosnia and Herzegovina.

Most amputees in Bosnia and Herzegovina have used the services of this thermal spa center at least once. Most return on a regular annual basis for continuing treatment.

Recently this thermal spa become the site where all persons with war related injuries including traumatic amputations are transferred from Libya to receive proper rehabilitation treatments. So it is not strange that there is a high interest in Mirror Therapy education and implementing it as regular daily based treatment at the spa.

Participants of the full day MT education according to End The Pain Project guidelines, received MT certificates entitling them to practice as mirror therapists. The Workshop was successfully led by Adria Mirror Therapy trainer, Jasmin Avdović.

The participants came from Bosnia and Herzegovina and neighboring Republic of Croatia and Republic of Slovenia. The participants from Croatia and Slovenia are the first mirror therapists in their countries.

Saturday, April 18, 2015

Mirror Therapy Training Workshop held in Macedonia a first!



Šejla Imamovic
Mirror Therapy Adria member, Šejla Imamovic recently conducted a Mirror Therapy Training Workshop  as part of the official First Physiotherapy Congress of the Republic of Macedonia in the capitol city of Skopje.



















Macedonian physiotherapists at Mirror Therapy Training Workshop
All twenty-five attendant physiotherapists participated interactively during this workshop, showing great enthusiasm for using this technique with both amputees suffering phantom limb pain and clients suffering hemiplegia.




Though the Republic of Macedonia suffered a only a brief time of conflict in the 90's, numerous land minefields were laid down, which caused some Macedonians to lose limbs.

Mirror therapy Adria plans to certify physiotherapists from the Republic of Macedonia this year so that Mirror Therapy as initiated by End The Pain Project will be spread throughout the former Yugoslavia.

Thursday, March 19, 2015

Rwandan Amputees Volunteer for Peer-To-Peer Mirror Therapy Programs in Refugee Camps

Rwandan Kiziba Refugee Camp Amputees and Family Supporters

In a first for Rwanda, 17 refugee amputees volunteered to become active in a Peer-to-Peer Mirror Therapy Group for End The Pain Project. They were part of a group of 50 amputees and family members who attended a recent Mirror Therapy for Phantom Pain Workshop held at the Kiziba Refugee Camp.

The idea of the peer-to-program was introduced by ETPP Representative for Africa, Jean Luc Ngarambe, who sees it as an effective limited budget model that can be extended to the greater African continent.

On a scale of 1-10, with '1' indicating no pain and '10' indicating excruciating pain, most of the volunteers had endured pain levels that hovered around '8'. Those who had limbs chopped off during the Rwandan genocide have endured intense levels of recurring phantom pain for over twenty years. Practicing with mirrors for thirty days, their pain levels will now be lowered to the point where they can function more effectively, below the 5-level, or no longer experiencing phantom limb pain.



Kiziba amputee at start of Mirror Therapy demonstration


Amputees watch the Mirror Therapy demonstration

Family members take notes on how to support amputees

These are the courageous and generous KizibaVolunteers who will become Certified ETPP Trainers, leading other amputees in Rwanda's refugee camp away from suffering phantom limb pain.

Gentille M., 24, lost right arm as a child in 1994 Rwandan genocide

Jean Leo B., 39, lost left leg in car accident

Agnes M., 36, lost left leg as a teen in 1994 Rwandan genocide

Alexandre N., 40, lost right arm in accident

Donatha N., 31, lost right arm as a child in 1994 Rwandan genocide
Emmanuel S., 48, lost left arm in 1994 Rwandan genocide

Evariste G., 44, lost left leg in 1994 Rwandan genocide

Andre M., 44, lost right leg in car accident

Tite M., 33, lost left hand as a teen in 1994 Rwandan genocide

Gerome N., 58, lost right leg in Rwandan genocide 1998

Herman N., 55, lost right leg in 1994 Rwandan genocide



Jack H., 35,  lost right leg as a teen in 1994 Rwandan genocide

 Jean Bosco R., 45, lost left leg in 1994 Rwandan genocide

Jean Bosco H., 39, lost right leg due to disease

Felician M., 43,  lost left hand due to a car accident

Pierre M., 26,  lost right hand as a child in 1994 Rwandan genocide

Jean Bosco U., 56, lost left leg in 1994 Rwandan genocide

Thursday, January 8, 2015

Peer-To-Peer Amputee Program Launches in Vietnam



Pham Qui Thi, Ban Advocate, presenting peer-to-peer Mirror Therapy with upper limb amputees
 With a donation of 20 table-top mirrors, ETPP ToolKits translated into Vietnamese and pain scales from End The Pain Project as well as the joint sponsorship of Handicap International and Project Renew, a mirror therapy workshop for twenty amputees in Hai Lang district, Quang Tri Province, Vietnam was kicked off on December 18, 2014.

Cluster munitions survivor Pham Quy Thi presented the concept of mirror therapy at home, followed by an actual mirror therapy session that lasted for 20 minutes supported by Pham Quy Thi and Nguyen Thanh Phu of the Project Renew Mine Action Visitor Center.

The participants were divided into two groups, one with leg amputations, the other with arm amputations.

 four out of the five upper limb amputee participants had positive feedback. They can really feel their missing fingers moving exactly like what existed before.
Lower limb amputee concentrating on a reflection of his intact leg

A man whose leg was amputated, said  he really could see his missing leg in the mirror after many years, and felt as if he can walk with balance.

Only in one case, a woman reported that she could not feel anything.  Later, she said that she misunderstood what the team had told her. Instead of concentrating on the reflected image of her leg, she just looked at her intact leg. It was concluded that this was the reason why,she did not get any reaction during the session.

Participants of the Mirror Therapy Workshop with instructors Mr. Nguyen and Mr. Pham
All the participants were very happy and and committed to following mirror therapy sessions  at home for one month.

Thursday, December 5, 2013

Pham Quy Thi upper limb amputee sheds 36 years of phantom limb pain with Mirror Therapy



Pham Quy Thi shares his amazing outcome with Robert Johnson PT

On November 23, 2013, Pham Quy Thi, a Vietnamese farmer, did not expect that his chronic phantom limb pain would be reduced just by concentrating on the movements of his intact hand in a mirror for ten minutes. Mr. Pham had lost his right arm in 1977 because of an exploding cluster bomb and suffered chronic pain in his phantom limb since then.

After just ten minutes of using Mirror Therapy, Mr. Pham exclaimed, "This is an amazing therapy! It is my very first time I have the chance to be experienced this and I know it works for me. I surely will bring this home and teach other survivors in my community”.

The fifty-eight-year-old was one of four land mine victims being trained by Robert Johnson of Achieve Orthopedic Rehabilitation and an Associate of End The Pain Project, to administer Mirror Therapy in a newly formed Peer-to-Peer program sponsored by Handicap International. The setting for this training workshop was the Mine Action Visitor Center run by Project RENEW in Dong Ha,Vietnam. 


Le Kien and Robert Johnson use a mirror to reduce Mr. Le's phantom limb pain
Mr. Le Kien was gardening in 1991 and struck a hidden cluster bomb. Not only did Mr. Le lose his left leg, he lost his baby daughter at the same time. Now a 55-year-old carpenter, he is a frequent guest speaker and story-teller at mine risk education programs for local school children.


In 1986, Hoang Xuan Phuong was tampering with an M14 mine also called a gravel mine in the vicinity of a former U.S. base when it exploded. Mr. Hoang was startled when he clearly 'saw' the mirror image of his lost arm. “It is the very first time, I can really recall my memory about my lost limb after more than twenty five years since the day I was amputated in a landmine blast”.


 Rear: Nguyen Thi Huong, Le Kien. Nguyen Xuan Tuan, Hoang Xuan Phuong, Phạm Quý Thí; Front: Phu Nguyen Thanh, Robert Johnson

The four volunteers at the Center also raise awareness of the many unexploded mines in Quang Tri Province and promote and advocate for the full application of the rights of persons with disabilities. 

This group was newly formed by Phu Nguyen Thanh, Facilitator/Support Staff at the Mine Action Visitor Center in August, 2013. Once the quartet have completed their own 30-day mirror therapies, they will go into surrounding communities to help other amputees still suffering phantom limb pain.








Tuesday, December 1, 2009

Virtual massage could relieve phantom limb pain for amputees


The Daily Mail of London, England, reported that amputees who experience phantom limb pain could find relief in a surprisingly simple way - by watching someone else rub their hands together.

The treatment seems to fool the brain that it is their missing hand being massaged, according to the American researchers, who worked with combat veterans. Phantom limbs occur when an amputee feels the often painful sensation of touch arising from a limb that is no longer present.

Lead researcher Vilayanur Ramachandran from the Centre for Brain and Cognition at the University of California, used newly discovered properties of mirror neurons to soothe the ache. Mirror neurons fire when a person performs an intentional action - such as waving - and also when they observe someone else performing the same action. They are thought to help us predict the intentions of others by creating a "virtual reality" simulation of the action in our minds.

"You also find cells like this for touch," says Ramachandran. "They fire when you touch yourself and when you watch someone else being touched in the same location."

Ramachandran and his colleague and wife Diane Rogers-Ramachandran used a "mirror box" - a tool that creates the visual illusion of two hands for people who actually only have one. By placing an amputee's arms either side of a mirror - with the missing limb on the non-reflective side, the amputee sees the reflection of their normal hand superimposed on the location of their missing hand.

Two amputees watched their normal hand being prodded, and both felt the remarkable sensation of "being prodded" in their missing hand. In another experiment, when the amputees watched a volunteer's hand being stroked, they too began to experience a stroking sensation arising from their missing limb.
The amputees "felt" the actions of others because their missing limb provided no feedback to partially inhibit their mirror neurons, no longer telling them that they were not "literally" being touched, says Ramachandran.

One woman reported that watching a volunteer rubbing her hand caused the cramping sensation within the phantom limb to cease for 10 to 15 minutes. "If you do it often enough perhaps this pain will go away for good," suggests Ramachandran. "If an amputee experiences pain in their missing limb, they could watch a friend or partner rub their hand to get rid of it."

Massaging the skin helps relieve a painful sensation by restoring blood flow and activating sensory fibres, which inhibit pain messages to the brain. By watching another person rubbing their hand, these amputees are apparently tapping into this latter mechanism, says Ramachandran.

"If performed early enough, this type of therapy may also be used to help stroke patients regain movements by watching others perform their lost actions," he concluded.

Sunday, November 1, 2009

Mirror Box Therapy from "Phantoms in the Brain" by Blakeslee & Ramachandran






Excerpted from The NY Review of Books Volume 55, Number 11 · June 26, 2008: How the Mind Works: Revelations by Israel Rosenfield & Edward Ziff

The problem of representation, meaning, and memory is also illustrated by the case of a patient who has lost his arm in an accident. As is often the case, the brain creates a "phantom" limb in an apparent attempt to preserve a unified sense of self. For the patient, the phantom limb is painful. The brain knows there is no limb; pain is the consequence of the incoherence between what the brain "sees" (no arm) and the brain's "feeling" the presence of a phantom that it has created in its attempt to maintain a unified sense of self in continuity with the past. Such pain is not created by an external stimulus and cannot be eliminated by painkillers.

One famous case is that of a young man who had lost his hand in a motorcycle accident. In a therapeutic procedure devised by V.S. Ramachandran, and described in his book with Sandra Blakeslee, Phantoms in the Brain, the patient put his intact hand in one side of a box and "inserted" his phantom hand in the other side. As the illustration on this page shows, one section of the box had a vertical mirror, which showed a reflection of his intact hand. The patient observed in the mirror the image of his real hand, and was then asked to make similar movements with both "hands," which suggested to the brain real movement from the lost hand. Suddenly the pain disappeared. Though the young man was perfectly aware of the trick being played on him—the stump of his amputated arm was lying in one section of the box—the visual image overcame his sense of being tricked. Seeing is believing! Pain—the consequence of the incoherence between the brain's creation of a phantom limb and the visual realization that the limb does not exist—disappeared; what was seen (a hand in the mirror) matched what was felt (a phantom).

According to the Italian neurologist Angela Sirigu, who used videos instead of mirrors to perform a similar experiment,

It is the dissonance between the image of oneself and the damaged body, that is at the origin of the phantom pain. Seeing the damaged hand once again functioning, reduces the dissonance even though the patient is aware of being tricked.

At one moment the patient experiences a painful phantom limb; at another he sees a mirror image of his intact hand and the pain disappears. This is only one of many neurological examples of what we might call the Dr. Jekyll and Mr. Hyde Syndrome: the patient in the experiment sees and remembers one world at certain times and a completely different world at other times.[4] The phantom limb is the brain's way of preserving a body image—a sense of self that is essential to all coherent brain activity. And as in the case of colors, the phantom limb suggests that what we see, hear, and feel are inventions of the brain—an integration of the past (the loss of the limb) and the present (a phantom that is essential for the brain's continuing to function "normally").

In general, every recollection refers not only to the remembered event or person or object but to the person who is remembering. The very essence of memory is subjective, not mechanical, reproduction; and essential to that subjective psychology is that every remembered image of a person, place, idea, or object inevitably contains, whether explicitly or implicitly, a basic reference to the person who is remembering.

Our conscious life is a constant flow, or integration, of an immediate past and the present—what Henri Bergson called le souvenir du présent (1908) and Edelman more recently called the remembered present (1989). Consciousness, in this view, is neither recalled representations nor the immediate present, but something different in kind (as colors are different in kind from the lightness and darkness of different reflected wavelengths).

The importance of body image and motor activity for perception, physical movement, and thought is suggested by the recent discovery of "mirror neurons" by Giacomo Rizzolatti and his colleagues. They observed that the neurons that fired when a monkey grasped an object also fired when the monkey watched a scientist grasp the same object. The monkey apparently understood the action of the experimenter because the activity within its brain was similar when the monkey was observing the experimenter and when the monkey was grasping the object. What was surprising was that the same neurons that produced "motor actions," i.e., actions involving muscular movement, were active when the monkey was perceiving those actions performed by others.


Phantoms in the Brain: Probing the Mysteries of the Human Mind
by V.S. Ramachandran and Sandra Blakeslee, with a foreword by Oliver Sacks
Quill, 328 pp., $16.00 (paper)

Mirrors in the Brain: How Our Minds Share Actions and and Emotions
by Giacomo Rizzolatti and Corrado Sinigaglia, translated from the Italian by Frances Anderson
Oxford University Press,242 pp., $49.95

A Universe of Consciousness: How Matter Becomes Imagination
by Gerald M. Edelman and Giulio Tononi
Basic Books, 274 pp., $18.00 (paper)