ClinicalTrials.gg
RecruitingNCT06106984Updated Oct 2, 2026

Home-based Rehabilitation Intervention for Phantom Limb Pain in Veterans With Lower Limb Amputations

An interventional study of Graded motor imagery mobile app in Phantom Limb Pain, sponsored by VA Office of Research and Development. Recruiting at 1 site in United States. Open to participants aged 18 Years to 89 Years. Per ClinicalTrials.gov, last updated 2026-10-02.

Sponsored by VA Office of Research and Development · Not applicable, Interventional, and Supportive care

From the registry’s dates

  • Started Apr 2024; still recruiting 2 years 7 months later.
Updated Oct 2, 2026Results publication addedEligibility revisedGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
36
Allocation
Not applicable
Ages
18 Years to 89 Years
Sex
All
01

Study summary

Nearly 60-85% of Veterans with amputations experience pain at the location of the amputated limb called phantom limb pain (PLP). PLP is a major problem and can have a profound impact on Veteran's daily function and ability to fully participate in life. Although several rehabilitation interventions are promising, advances in novel rehabilitation interventions are limited. The objective of this project is to refine a mobile app for graded motor imagery in 12 Veterans with amputations and test the mobile app with 36 Veterans with amputations. For this pilot project, the investigators will measure the preliminary feasibility and acceptability of the intervention. Knowledge from this project will provide evidence to guide future larger studies of this graded motor imagery intervention. Developing novel strategies for chronic pain in this population will positively impact quality of life for Veterans with amputations.

Read the detailed description

Background: Phantom Limb Pain (PLP) is a form of unpredictable neuropathic pain in Veterans with amputation. Current non-medication treatments for PLP are limited and more interventions are needed that take into consideration the unique needs of the Veteran population. PLP significantly impairs rehabilitation outcomes and community participation. One non-medication intervention is graded motor imagery (GMI). GMI consists of sequentially progressing from limb laterality training, to motor imagery, and then mirror therapy (i.e., observing movement using the visual illusion of an intact limb in a mirror). Although clinicians report benefit from use of the technique, barriers exist to supporting at-home use of the intervention.

Research Questions (Objectives) - This VA Career Development Award-2 proposal focuses on refining a mobile app for GMI (VA-GMI) (Aim 1) and then pilot testing serial sessions of mobile app use in a sample of Veterans with lower limb amputation and moderate to severe PLP in their home setting (Aim 2).

Relevance to VA - There is a growing population of Veterans with amputation in the VA system. Many of whom will experience amputation pain, like phantom limb pain, and other amputation-related experiences. There are currently limited non-drug treatment options for phantom limb pain. Graded Motor Imagery could be one tool as a part of a comprehensive treatment plan for phantom limb pain. With the support of the expert mentor team in place, this work will incorporate Veteran input into the design of a novel intervention with high translational value. This work will lead to future investigations of optimized GMI intervention for the reduction of PLP in Veterans with amputations.

Number of Research Participants (Sample Size) - For Aim 1 that involves refining the mobile app, the investigators will recruit 12 Veterans. For Aim 2 that involves the clinical trial, the investigators will recruit 36 Veterans with unilateral below knee amputation to participate in the pilot testing of serial sessions.

Participating Sites - Minneapolis VA Health Care System

Duration of Participant Intake (Study Duration) - This project is projected to occur over 5 years. This project will begin with a 1 year refinement of the investigators' Graded Motor Imagery mobile app with 12 Veterans with amputation and moderate to severe PLP. In years 2-5, the investigators will conduct a pilot study to evaluate the feasibility and acceptability of the intervention with 36 Veterans with amputation and moderate to severe PLP. The investigators will conduct this study virtually with all Veterans in their home environment. All Veterans will receive twelve intervention sessions. Recruitment will conclude with 6-months remaining in the study timeline, which will be used for the dissemination of results and closure of the project.

Treatment (follow-up) - The Veterans in the pilot study will have 12 sessions of Graded Motor Imagery using the mobile app. The investigators will then follow Veterans for 3 and 6 month follow ups to learn more about their perspective of the Graded Motor Imagery mobile app.

Endpoints - The primary outcomes for this study are acceptability (Acceptability of Intervention Measure) and secondary measures of health outcomes, specifically pain interference (Amputation Related Pain and Experiences).

Qualitative Data - In addition to measuring acceptability and pain interference, the investigators will conduct semi-structured interviews with participants to develop further understanding of the benefits and drawbacks of Graded Motor Imagery in the home setting, using the mobile app.

02

Conditions studied

  • Phantom Limb Pain

Keywords

  • Amputation
  • Rehabilitation
  • Phantom limb pain
  • Pain
03

In context

Phantom Limb

163 studies on the registry are indexed under Phantom Limb; 35 are open to participants now.

This study's planned enrollment of 36 is above the median of 30 across 125 interventional studies indexed under Phantom Limb.

Browse Phantom Limb studies →

Lead sponsor

VA Office of Research and Development is the lead sponsor of 1,771 studies on the registry; 392 are open to participants now.

Of its 213 completed or terminated interventional studies of FDA-regulated products, 185 (87%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

The criteria were revised on the registry on Oct 2, 2026. See what changed

Ages eligible
18 Years to 89 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Must be a military Veteran
  • >1 year since unilateral below knee amputation
  • Moderate or severe (NRS score 4 on a 0-10 scale) PLP
  • Stable medications over the past 2 weeks
  • Willing and able to give
  • Able to participate in the telehealth study activities with a personal device

Exclusion criteria

Exclusion Criteria:

  • Unstable medical conditions (e.g., uncontrolled diabetes, heart failure exacerbation)
  • Unstable mental illness or substance use disorder (e.g., active suicidality or psychosis)
  • Unable to give due to a cognitive impairment
  • Fibromyalgia or complex regional pain syndrome-like symptoms
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
36 participants (estimated)

Study arms

  • Experimental
    Intervention

    Veterans will trial the Graded Motor Imagery mobile application.

    Device: Graded motor imagery mobile app

Interventions

  • DeviceGraded motor imagery mobile app

    The Graded Motor Imagery mobile app is a mobile app designed for intervention in phantom limb pain.

06

What researchers measure

Primary outcomes

  1. Acceptability of Intervention Measure

    The Acceptability of Intervention Measure is a measure of the acceptability of the intervention sessions and if acceptability changes over time. This measure will evaluate the acceptability of using a mobile app with a telehealth platform. Minimum score: 12, maximum score: 60. A higher score indicates greater acceptability of the intervention, a lower score indicates lower acceptability of the intervention.

    Time frame: 6-week post-test

  2. Change from 6-week post-test on the Acceptability of Intervention Measure to 6 months

    The Acceptability of Intervention Measure is a measure of the acceptability of the intervention sessions and if acceptability changes over time. This measure will evaluate the acceptability of using a mobile app with a telehealth platform. Minimum score: 12, maximum score: 60. A higher score indicates greater acceptability of the intervention, a lower score indicates lower acceptability of the intervention.

    Time frame: 6 month follow up (an average of 24 weeks from 6-week post test)

Secondary outcomes

  1. Change from baseline Amputation Related Pain and Experiences to 6-weeks (post-test)

    The Amputation Related Pain and Experiences is a measure to differentiate types of amputation-related pain and measure intensity, frequency, and pain interference with residual limb, phantom sensation, and phantom limb pain. For each section of residual limb pain, phantom sensation, and phantom limb pain, the minimum score is 0 and the maximum score is 60. A higher score indicates greater pain or sensation in each of the categories and a lower score indicates lower pain or sensation in each of the categories.

    Time frame: Baseline, 6-week Post-Test

  2. Change from 6-week post-test on the Acceptability of Intervention Measure at 3 months

    The Acceptability of Intervention Measure is a measure of the acceptability of the intervention sessions and if acceptability changes over time. This measure will evaluate the acceptability of using a mobile app with a telehealth platform. Minimum score: 12, maximum score: 60. A higher score indicates greater acceptability of the intervention, a lower score indicates lower acceptability of the intervention.

    Time frame: 3 month follow up (an average of 12 weeks after baseline)

  3. Change from 6-week post-test Amputation Related Pain and Experiences to 3 months

    The Amputation Related Pain and Experiences is a measure to differentiate types of amputation-related pain and measure intensity, frequency, and pain interference with residual limb, phantom sensation, and phantom limb pain. For each section of residual limb pain, phantom sensation, and phantom limb pain, the minimum score is 0 and the maximum score is 60. A higher score indicates greater pain or sensation in each of the categories and a lower score indicates lower pain or sensation in each of the categories.

    Time frame: Baseline, 3 month follow up (an average of 12 weeks from baseline)

  4. Change from baseline Amputation Related Pain and Experiences to 6 months

    The Amputation Related Pain and Experiences is a measure to differentiate types of amputation-related pain and measure intensity, frequency, and pain interference with residual limb, phantom sensation, and phantom limb pain. For each section of residual limb pain, phantom sensation, and phantom limb pain, the minimum score is 0 and the maximum score is 60. A higher score indicates greater pain or sensation in each of the categories and a lower score indicates lower pain or sensation in each of the categories.

    Time frame: Baseline, 6 month follow up (an average of 24 weeks from baseline)

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Rich TL, Cristan KG, Truty TP, Hansen AH, Ackland PE. HUMAN CENTERED DESIGN: VETERAN TESTING OF A MOBILE APP WITH AUGMENTED REALITY FOR PHANTOM LIMB PAIN. Proc Des Med Devices Conf. 2025 May 24;2025:10.1115/dmd2025-1021. doi: 10.1115/dmd2025-1021. PubMed 41836102 ↗
  • Rich TL, Cristan KG, Marth L, Ackland PE. Pain Neuroscience Education for Postamputation Pain and Functioning: Testing Embedded Education in a Mobile App for Occupational Therapy Pain Treatment. Am J Occup Ther. 2026 May 1;80(3):8003185070. doi: 10.5014/ajot.2026.051449. PubMed 41871396 ↗

Individual participant data

Plan to share: No

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Apr 2024 (actual). Primary completion is estimated for Nov 2028, 55 months after the start.

Of 61 non-industry interventional studies with no phase under Phantom Limb, half reached primary completion within 32 months of starting (the median), counting those still running; a quarter within 12 and three quarters within 47. This study's planned 55 months is above that.

Counting every sponsor, half of 64 studies reached it within 34 months; a quarter within 13 and three quarters within 50.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 24, 2023
First posted
Oct 30, 2023
StartActual
Apr 1, 2024
Primary completionEst.
Nov 30, 2028
CompletionEst.
Mar 31, 2029
Last update
Oct 2, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Eligibility
1 inclusion criterion edited, 1 removed; 1 exclusion criterion edited
What changed in the criteria
Inclusion criteria
  • RemovedAt least 18 years old;
  • EditedWilling and able to give informed consent; and
Exclusion criteria
  • EditedUnstable mental illness or substance use disorder (e.g., active suicidality or psychosis); and
Oct 2, 2026
Publications
Results publication added: Rich TL, Cristan KG, Truty TP, Hansen AH, Ackland PE. HUMAN CENTERED DESIGN: VETERAN TESTING OF A MOBILE APP WITH AUGMENTED REALITY FOR PHANTOM LIMB PAIN. Proc… PubMed 41836102 ↗; 1 more
Oct 2, 2026
Show all 1 update
  1. Oct 2, 2026
    Publications Results publication added: Rich TL, Cristan KG, Truty TP, Hansen AH, Ackland PE. HUMAN CENTERED DESIGN: VETERAN TESTING OF A MOBILE APP WITH AUGMENTED REALITY FOR PHANTOM LIMB PAIN. Proc… PubMed 41836102 ↗; 1 more
    Eligibility 1 inclusion criterion edited, 1 removed; 1 exclusion criterion edited
    What changed in the criteria
    Inclusion criteria
    • RemovedAt least 18 years old;
    • EditedWilling and able to give informed consent; and
    Exclusion criteria
    • EditedUnstable mental illness or substance use disorder (e.g., active suicidality or psychosis); and
    + 3 other changes: identifiers, verification date and contact details

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT06106984
Responsible party
Sponsor
First posted
Oct 30, 2023
Start date
Apr 1, 2024
Primary completion
Nov 30, 2028 (estimated)
Completion
Mar 31, 2029 (estimated)
Last update
Oct 2, 2026

Study contacts

Tonya L Rich, PhD MA BS
Contact
Tonya.Rich@va.gov
(612) 467-5463
Andrew H Hansen, PhD
Contact
andrew.hansen2@va.gov
(612) 467-2910
Tonya L Rich, PhD MA BS
principal investigator · Minneapolis VA Health Care System, Minneapolis, MN

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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