Nekhanevych O. B., Krapiva D. M.

THE IMPACT OF VIRTUAL REALITY TECHNOLOGIES ON MICROCIRCULATION HARDWARE PARAMETERS AND PAIN SYNDROME IN SERVICEMEMBERS DURING PRE-PROSTHETIC REHABILITATION FOLLOWING TRANSFEMORAL AMPUTATIONS

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About the author:

Nekhanevych O. B., Krapiva D. M.

Heading:

THERAPY AND REHABILITATION

Type of article:

Scientific article

Annotation:

The ongoing full-scale military aggression against Ukraine has led to a dramatic surge in patients with blast-related injuries, frequently resulting in transfemoral amputations. One of the most formidable challenges in pre-prosthetic rehabilitation is phantom limb pain (PLP), with a prevalence reaching 80%. PLP acts as a potent stressor that activates the sympathoadrenal system, causing persistent vasoconstriction and impaired microcirculation within the residual limb. This triggers a “pain–vasospasm–pain” vicious cycle, hindering successful prosthetic fitting. Traditional pain assessment via the Visual Analogue Scale (VAS) is inherently subjective, necessitating the use of objective biomarkers such as the Perfusion Index (PI). The aim of the study is to optimize rehabilitation outcomes by validating the clinical efficacy of integrating Virtual Reality (VR) technologies into physical therapy programs for PLP management and analyzing the dynamics of microcirculatory processes in patients following lower limb amputations. A prospective cohort study was conducted involving 50 men (mean age 34,5±7,56 years) with transfemoral amputations. Patient randomization was performed using AI (ChatGPT PRO). The experimental group (Group I, n=25 ) received physical therapy enhanced by VR (immersive neuromodulation), while the control group (Group II, n=25 ) followed a standard protocol. Monitoring occurred at 14, 28, and 42 days post-surgery. Objective clinical status was assessed by measuring the PI using the Masimo Set iSpO2 device, alongside subjective VAS pain scoring. Patient flow and outcomes were visualized using alluvial diagrams (SankeyMATIC). At baseline (Day 14), groups were homogeneous (p>0.05). Day 28 (the onset of active verticalization) emerged as a critical juncture; in the control group, pain scores escalated to 6.28±1.7, accompanied by vasospasm (PI dropped to 1.5). In the experimental group, VR effectively mitigated the pain peak (VAS=3.84 ±1.75) and facilitated a PI increase to 2.8. By Day 42, the VR group demonstrated stable analgesia (3.72±1.5) compared to high pain levels in the control group (5.72±1.8; p<0.0001). Sankey diagrams confirmed that 80% of VR group patients exhibited a correlation between low pain levels and high perfusion (PI>2.5). Conversely, 65% of the standard therapy group showed pain chronification and vascular dysfunction (PI<1.8). Clinical case studies confirmed the role of VR as a neurodynamic damper preventing physiological decompensation during the walking phase. The integration of VR provides effective neuromodulation, overcoming the sympathoadrenal response to pain. A direct correlation was established between VR utilization, reduced PLP intensity, and improved microcirculation. The Perfusion Index (PI) is recognized as a reliable prognostic marker for rehabilitation success. The application of this innovative program disrupts the vasospasm vicious cycle and yields an 80% improvement in outcomes compared to standard methods.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 3, 182, 508-513 pages, index UDC 617.57/.58-089.873-057.36-036.82:615.825]-07:612.13:57.089.2

DOI:

10.29254/2077-4214-2026-3-182-508-513