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November 16, 2006

BehindTheMedspeak: Virtual Treatment for Phantom Pain


From the University of Manchester in England comes a world first: "a virtual reality system that can help amputees cope with 'phantom pain' by giving them the illusion that their missing limb is still there," wrote Michelle Healy in today's USA Today.

In a November 13, 2006 Manchester Evening News interview the project leader, Dr. Craig Murray of the university's School of Psychological Sciences said of one amputee in the study, "After just one session using the virtual system she began to to feel movement in her fingers and the pain began began to ease."

Here's a link to the University of Manchester's November 14, 2006 press release on the work.

For those who wish to explore the subject in more depth, here's a link to the project's website; its content follows.

    Virtual Reality as a Rehabilitative Technology for Phantom Limb Experience

    PIs: Craig D. Murray (School of Psychology) and Steve Pettifer (School of Computer Science, AIG).

    The relationship between phantom limb pain (PLP), prosthesis use and psychological well-being is an intimate one. For instance, significant correlations have been observed between adjustment to amputation and pain (Katz, 1992; Marshall, Helmes and Deathe, 1992), with adjustment to amputation less likely as levels of pain increase. Amputees with PLP are less likely to use a prosthetic limb (Dolezal, Vernick, Khan, Lutz and Tindall, 1998). In a survey of 685 lower-limb amputees, Knight and Urquhart (1989) found 38% of the sample did not use a prosthesis with pain being cited as the primary reason. Non-prosthesis use often results in the restriction of normal activities (such as self-care, visiting friends and carrying out domestic work), and is associated with higher levels of depression (Williamson, Schulz, Bridges, and Behan, 1994). The problem of PLP then is large and pervasive in many amputees' lives.

    While a range of pharmaceutical, surgical and psychological interventions are used to treat PLP, the success of these approaches is often limited and short-term. However, one promising development in this regard was reported by Ramachandran (1993). Ramachandran (1993) created a mirror box made by placing a vertical mirror inside a cardboard box with the top removed, in which the amputee places their remaining anatomical limb inside and views a reflection in the visual space occupied by their phantom limb. He reports anecdotal evidence that the box was able to induce in patients vivid sensations of movement originating from the muscles and joints of their phantom limb. For some patients their phantom limb pain was relieved and others were able to gain control over 'paralysed' phantoms'. The mirror box has also recently been used with similar success with lower-limb amputees, where viewing a reflection of an anatomical limb in the phenomenal space of a phantom limb resulted in amputees reporting a significantly greater number of movements of their phantom limb than with attempted movement alone (Brodie, Whyte and Waller, 2003). Ramachandran himself recognized that a more controlled study was required to determine if this was a placebo effect or the direct result of providing visual feedback with the mirror. While the above work and theory indicates that the mirror box may be an effective treatment for negative phantom limb experience, as yet there are no controlled studies which have explored the number and lengths of mirror box sessions necessary to effect change, how long such change lasts for, which types of amputation and phantom limb phenomenology respond best, psychological variables which predict who will respond best to such therapy, and any potential negative responses to mirror box therapy.


    Blakemore, Wolpert and Frifth (2002) explain the mirror box phenomenon in terms of a central nervous system internal forward model in which the body and its interaction with the world are represented. The forward model predicts the sensory consequences of motor commands whenever movements are made. This means that the normal experience of a limb is based upon a predicted rather than an actual state. In the absence of a limb motor commands are still made, so that if a prediction of movement is made then movement will be experienced in a phantom limb. However, because the limb does not actually move there is a discrepancy between these predicted and actual states. With time the forward models will adapt to this situation, so that movement is no longer experienced in a phantom even when motor commands to do so are issued. Therefore, when Ramachandran found that a mirror-box was able to restore voluntary movement of a phantom limb, then, according to Blakemore, Wolpert and Frifth (2002), this was because the forward models were updated. The efference copy produced in parallel with the motor commands generates changes in the predicted position of the amputated limb that matched what the amputee had seen in the mirror.

    The above work and theory on the mirror box suggest that other visual therapies that work in similar ways may also relieve phantom limp pain as well as increasing volitional movement in phantom limbs. One example of this would be virtual reality (VR) technology, such as the combination of an immersive head- mounted display, instrumented peripheral devices and computer graphics. The proposed research is intended to build upon the insights of Ramachandran's mirror box by producing a similar phenomenon using virtual technologies. VR offers an opportunity to provide a visual representation of the amputee's whole body, including their phantom limb. Unlike the mirror box, which confines participants' limbs to a narrow spatial dimension, VR enables complex hand-eye coordination, and both fine and gross motor movements of the fingers, hand and arm, and toes, feet and legs. Users of such virtual limbs can engage in tasks made impossible by the mirror box, such as pegboard tasks, racket games, ball games, etc. It is hope that such VEs will prove to be a therapeutic treatment for phantom limb pain, as well as aiding successful prosthesis use.

    This project aims to produce virtual facsimiles of amputees' phantom limbs; to obtain appropriate measurements that enable conclusions to be reached about the efficacy of VR in the treatment of phantom pain; and to obtain appropriate measurements that enable conclusions to be reached about the efficacy of VR in decreasing body image dissatisfaction and encouraging and enabling successful prosthesis use.



Note to self: get on over to my Second Life outpost and tweak it [more than] a bit; it's past time I got aboard this cluetrain in a serious way.

November 16, 2006 at 04:01 PM | Permalink | Comments (0) | TrackBack

'Guide to Bodily Fluids'


You won't be able to put it down.

Trust me — I'm a doctor and I learned more about what's circulating inside from this book than I ever dreamed existed back in medical school.

A must-have in the throne room.

From the website:

    "Guide to Bodily Fluids" — Everything you wanted (and didn't want) to know, but were afraid to ask!

    Easy-to-read book deals with bodily functions and all excreta in a humorous (and serious) way.

    Includes subjects like Sweat, Saliva, Toe Cheese (okay... ewwwww!), Belly Button Lint, Earwax, etc.

    Chock full of amazing facts about the amazing uses of human waste both past and present.

    Takes the mystery out of current taboos.

    Many bodily functions are explained with multiple viewpoints: scientific, historical, mythological, sociological & artistic.

    147 pages.


The perfect companion volume to "Toilets of the World."


November 16, 2006 at 03:01 PM | Permalink | Comments (3) | TrackBack

All I want for Christmas is my two front teeth — and a blue Google t-shirt


Okay, Mountain View joeheads: now's the time.

Email me if you've got one for me.

What brought on this frisson of need was Chris Nuttall's November 8, 2006 Financial Times column in which he related how he'd interviewed Sergey Brin who, when Nuttall pointed out something Google could do better, told Nuttall he had earned a blue Google t-shirt.

November 16, 2006 at 02:01 PM | Permalink | Comments (0) | TrackBack

Speaking Card — 'Really send a message'


From the website:

    Voice Card

    Add a personalized recorded message to the gifts you give.

    Rather than searching for "just the right card" to send along with a gift, record a 10-second personal message in your own voice!

    Paper-thin voice "card" clips onto a document or object.

    There's even room to stick your own "sticky" note.

    Message is retained even if button battery (included) dies or is removed.

    LED record/playback indicator.

    2-1/2"W x 4-1/4"H x 1/4"D.


Bag the gift — plenty of possibilities in the card space with this puppy.

A set of two — one red, one black — is $9.99.

November 16, 2006 at 01:01 PM | Permalink | Comments (0) | TrackBack

Teri Horton visits bookofjoe


I woke up this morning to see, over in the "Recent Comments" area to the right, "Teri Horton on What Teri Horton can teach us about life — if we listen very carefully."


Nothing makes me happier than hearing from people I admire.

Anyhow, she offered a Teri-esque comment on the whole kerfuffle surrounding her and her painting.

Thanks, Teri!

Of interest to me was that she used a bad word I'd have thought TypePad's RoboSpamBlocker would've flagged, thus preventing her comment from appearing.

Yet it came through just fine, while totally unremarkable comments are consistently firewalled by TypePad — and believe me, I hear about it, at least once every day.

Nothing I can do about it, gang.

As Bob Dylan and Sonny & Cher sang, in a different context in a different era — "It ain't me, babe."


I got to wondering how it was that Teri Horton found me, an idiotstick blogger in a Podunk town.

So I put "Teri Horton" into the Google search box.

The results appear up top.

Number 4 on a list of 272,000 — not half bad.

I guess nowheresville isn't what it used to be.

November 16, 2006 at 12:01 PM | Permalink | Comments (0) | TrackBack

Storytime Rocking Chair — 'Seats Four'


My favorite chair of the year.

Hal Taylor, a custom rocking chair maker in Fredericksburg, Virginia, wanted to read to his three small children while they all shared a conventional rocking chair.

He found it impossible.

So he invented the "Storytime" chair (above, with Taylor and his three kids, and below).

It's a four-passenger rocker with a child-sized ledge on each arm.

Annie Groer featured it in an item in today's Washington Post Home section.

The good news: it's not a prototype — you can buy one for you and yours.

Taylor will be at the 19th annual Washington [D.C.] Craft Show this weekend — Friday, November 17 through Sunday, November 19.

The location: Washington Convention Center: 801 Mount Vernon Place, NW; 800-832-7813; www.craftsamericashows.com; Admission: $14.

Tell him joe sent you.

It won't change anything but it'll amuse me.

Don't worry — I'll know.

November 16, 2006 at 11:01 AM | Permalink | Comments (2) | TrackBack

'Antiques of the Future'


That's the title of Philadelphia architect and designer Lisa S. Roberts's new book.

Annie Groer wrote about it and the concept behind it in a story which appear's in today's Washington Post Home section, and follows.

    What's New in Old

    The word "antique" often means very old and very pricey.

    Not to Philadelphia architect and designer Lisa S. Roberts. Since the early 1980s, she has amassed more than 300 high-style objects for the home. This month, 75 of them appear in her hip, accessible guide, "Antiques of the Future" (Stewart, Tabori & Chang, $29.95).

    It features such classics as Karim Rashid's 1996 plastic Garbo trash can ([above]; $12), Philippe Starck's 1998 Dr. Kiss toothbrush and pedestal ($15) and Jonathan Ive's 1998 Apple computer ($1,200). Her entire collection can be seen at http://www.antiquesofthefuture.com.

    To qualify for future antique-dom, objects must have been in a museum show or permanent collection; created by a noted architect or designer; made by a design-oriented firm; widely published; or given major design awards. Although many of her favorites were made by the millions (Oxo veggie peelers, Voss water bottles), she predicts they'll gain value when out of production.

    Roberts, who makes two Washington appearances next month, urges new collectors to read design magazines (listed in the book) and shop at such style-conscious venues as Target and New York's Museum of Modern Art. But they absolutely must not open the package or use any item.

November 16, 2006 at 10:01 AM | Permalink | Comments (0) | TrackBack

$100 Bills Belt Buckle


From the website:

    $100 Bills Belt Buckle

    There’s nothing like real cash money to impress the ladies — and there’s nothing like wearing this $100 Bills Belt Buckle on your belt to give them something interesting to look at.

    Plastic-coated oversized bills stand up to all the thrills and spills you can work yourself into.

    Buckle is 5" long and fits belts up to 2" wide.


Excuse me?

Where does it say, "Fits men sizes...?"

I know lots of men who'd be plenty impressed by a lady sporting one of these.


November 16, 2006 at 09:01 AM | Permalink | Comments (3) | TrackBack

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