{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:21:09Z","timestamp":1791976869120,"version":"4.4.0"},"reference-count":59,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Phantom limb pain (PLP) affects 64% of individuals who have undergone amputation. Various theories explain its development, leading to different treatments, including graded motor imagery. This study analyses the effectiveness of a home\u2010based intervention protocol based on graded motor imagery (GraMI protocol) as a treatment for phantom limb pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A randomised, controlled, home\u2010based, assessor\u2010blinded clinical trial was conducted on individuals over 18\u2009years old, with limb amputation, pharmacologically stable and discharged home. Participants followed the GraMI protocol or continued their current treatment for 9\u2009weeks. Assessments were conducted at baseline, postintervention and at 3\u2009months follow\u2010up, evaluating PLP, quality of life, functionality and depressive symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study enrolled 36 participants (mean age of 58.5\u2009years), including 27 individuals with lower limb amputation and nine with upper limb amputation. Vascular issues were the primary cause, and 17 participants experienced preamputation pain. None of the participants in the control group received any PLP treatment during the study. Compliance with treatment among participants in the experimental group during the laterality recognition and explicit motor imagery phases was satisfactory, averaging 91.4%. Significant differences were found between groups in PLP (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), persisting 12\u2009weeks postintervention (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05). Within\u2010group analysis revealed clinically significant PLP improvements postintervention (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), and these improvements remained statistically significant 12\u2009weeks later (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). There were no statistically significant differences observed in the rest of the variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The GraMI protocol shows effectiveness in reducing PLP in individuals who have undergone amputation, with this effect persisting 12\u2009weeks after the intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance Statement<\/jats:title>\n                    <jats:p>Phantom limb pain significantly impacts individuals with amputations, yet effective treatments remain limited. This study is crucial as it evaluates a home\u2010based graded motor imagery (GraMI) protocol, offering a noninvasive, accessible intervention. The randomised clinical trial demonstrates GraMI's effectiveness in reducing PLP, with lasting effects up to 12\u2009weeks. By addressing PLP, this research contributes to improving patients' quality of life, functionality and psychological well\u2010being. Its findings support integrating GraMI into rehabilitation programs, providing evidence for a cost\u2010effective, home\u2010based therapeutic option.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier: NCT05083611<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.70167","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T07:48:39Z","timestamp":1763538519000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Graded Motor Imagery (\n                    <scp>GRAMI<\/scp>\n                    Protocol) for Phantom Limb Pain: A Randomised Clinical Trial of Home\u2010Based 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Vic\u2010Central University of Catalonia (UVic\u2010UCC)  Vic Spain"},{"name":"Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS\u2010CC)  Vic Spain"},{"name":"Pain Medicine Section, Anaesthesiology Dept, Hospital Clinic de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergi","family":"Grau\u2010Carri\u00f3n","sequence":"additional","affiliation":[{"name":"Digital Care Research Group, Faculty of Science, Technology and Engineering, Centre for Health and Social Care Research University of Vic\u2010Central University of Catalonia  Vic Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirari","family":"Ochandorena\u2010Acha","sequence":"additional","affiliation":[{"name":"Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M<sub>3<\/sub>O), Faculty of Health Sciences and Welfare Centre for Health and Social Care Research (CESS), University of 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