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This article presents a theoretical basis for Progressive Motor Training (PMT), derived from the Stochastic Entanglement hypothesis, combining motor imagery and execution to progressively recruit affected motor circuitry and address limits of existing 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\n[https://doi.org/10.1186/s12984-025-01790-x](https://doi.org/10.1186/s12984-025-01790-x)  \nJournal of NeuroEngineering and Rehabilitation  \nCOMMENT Open Access  \nTheoretical foundations of Progressive Motor  Training (PMT) for Phantom Limb Pain  \nMax Ortiz-Catalan 1,2*  \nAbstract  \nPhantom Limb Pain (PLP) remains highly prevalent despite decades of clinical and experimental interventions. While pharmacological and surgical approaches address acute or nociceptive components, chronic neuropathic PLP persists, and theoretical models often lack testable predictions. Here, I present the theoretical basis for Progressive Motor Training (PMT), a novel treatment derived from the Stochastic Entanglement hypothesis.  \nThis hypothesis proposes that PLP arises from maladaptive recruitment of underutilized somatosensory and motor circuits after amputation, rather than cortical reorganization or visual feedback deficits. PMT combines motor imagery and motor execution to maximize recruitment of the affected motor circuitry in a progressive, comprehensive, and adaptive manner. It is designed to overcome limitations of existing motor training therapies, such as Mirror Therapy and Phantom Motor Execution, by being applicable across amputation levels and clinical contexts, including early post-surgical stages where current technology-based interventions are impractical. Therefore, PMT can help to preserve phantom movement and hypothetically reduce PLP incidence when applied early. Overall, PMT offers a theoretically grounded, resource-efficient, and clinically flexible alternative for both treatment and prevention of PLP. Its efficacy alleviating PLP now requires systematic empirical evaluation.  \nBackground  \nPhantom Limb Pain (PLP) is a common condition after limb amputation, and despite a myriad of treatments available [1], its prevalence has remained over 60% for the last 50 years [2, 3]. Pharmacological approaches have proven useful in acute, but not in chronic PLP, and can carry considerable side effects [4]. Recent surgical developments in which the severed nerves are provided with biological targets have shown promising results alleviating neuroma pain and nociceptive induced PLP [5]. However, they have been less successful with chronic neuropathic PLP. The underlying mechanisms producing  \n*Correspondence: Max Ortiz-Catalan [maxortizc@outlook.com](maxortizc@outlook.com)  \n1Prometi Pain Rehabilitation Center, Vinnytsia, Ukraine  \n2Center for Complex Endoprosthetics, Osseointegration, and Bionics, Kyiv, Ukraine  \nand maintaining PLP, beyond nociception from the severed nerves, remain unclear [6]. This might be the reason for which therapeutic approaches are frequently derived from intuition and often lack theoretical justification.  \nMirror Therapy [7], one of the most common therapies for PLP, exemplifies the aforementioned situation and illustrates the challenges in treating PLP. Mirror Therapy has been shown to achieve near-complete alleviation in randomized controlled trials (RCTs) [8], however, widescale implementation with similar outcomes has not been as successful [9]. This is arguably because of the lack of a standardized protocol [10], which one can argue reflects the lack of a clearly understood theoretical basis. Here, I present the theoretical basis of a novel treatment for PLP, namely Progressive Motor Training (PMT), with the intention to aid on its scientific exploration and clinical implementation.  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in t","cbCaib1IO1JXuUbN","https://ap.wps.com/l/cbCaib1IO1JXuUbN","pdf",812323,"English","# Abstract\n# Background\n## Hypothesis on the pathogenesis of PLP","[{\"question\":\"What is the main theoretical goal of Progressive Motor Training (PMT) for PLP?\",\"answer\":\"PMT aims to provide a theoretically grounded treatment basis for PLP with mechanisms that allow progressive recruitment of affected motor circuitry, rather than relying on cortical reorganization or visual feedback deficits.\"},{\"question\":\"How does PMT differ from existing motor training approaches mentioned in the article?\",\"answer\":\"The article describes PMT as overcoming limitations of therapies such as Mirror Therapy and Phantom Motor Execution by being applicable across amputation levels and clinical contexts, including early post-surgical stages.\"},{\"question\":\"Why does the article argue that current PLP therapies often lack theoretical justification?\",\"answer\":\"It states that many approaches are frequently derived from intuition and may lack explicit testable predictions or a standardized theoretical protocol, which complicates scientific exploration and clinical implementation.\"}]","Theoretical foundations of Progressive Motor Training (PMT) for Phantom Limb Pain | PDF",1790741543,15]