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Cross-Sectional Assessment of Factors Related to Pain Intensity and Pain Interference in Lower Limb Prosthesis Users.

Citation
Morgan, S. J., et al. “Cross-Sectional Assessment Of Factors Related To Pain Intensity And Pain Interference In Lower Limb Prosthesis Users.”. Archives Of Physical Medicine And Rehabilitation, pp. 105-113.
Center University of Washington
Author Sara J Morgan, Janna L Friedly, Dagmar Amtmann, Rana Salem, Brian J Hafner
Keywords amputation, Artificial limbs, Back, Health surveys, Knee, Pain, Phantom limb, rehabilitation, Shoulder
Abstract

OBJECTIVE: To determine relationships between pain sites and pain intensity/interference in people with lower limb amputations (LLAs).

DESIGN: Cross-sectional survey.

SETTING: Community.

PARTICIPANTS: Lower limb prosthesis users with unilateral or bilateral amputations (N=1296; mean time since amputation, 14.1y).

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Patient-Reported Outcomes Measurement Information System (PROMIS) pain intensity (1 item to assess average pain), PROMIS pain interference (4-item short form to assess the consequences of pain in desired activities), and questions that asked participants to rate the extent to which each of the following were a problem: residual limb pain (RLP), phantom limb pain (PLP), knee pain on the nonamputated side, back pain, and shoulder pain.

RESULTS: Nearly three quarters (72.1%) of participants reported problematic pain in 1 or more of the listed sites. Problematic PLP, back pain, and RLP were reported by 48.1%, 39.2%, and 35.1% of participants, respectively. Knee pain and shoulder pain were less commonly identified as problems (27.9% and 21.7%, respectively). Participants also reported significantly (P<.0001) higher pain interference (T-score ± SD, 54.7±9.0) than the normative sample based on the U.S. population (T-score ± SD, 50.0±10.0). Participants with LLAs rated their pain intensity on average ± SD at 3.3±2.4 on a 0-to-10 scale. Pain interference (ρ=.564, P<.0001) and intensity (ρ=.603, P<.0001) were positively and significantly correlated with number of pain sites reported.

CONCLUSIONS: Problematic pain symptoms, especially RLP, PLP, and back pain, affect most prosthetic limb users and have the potential to greatly restrict participation in life activities.

Year of Publication
2017
Journal
Archives of physical medicine and rehabilitation
Volume
98
Issue
1
Number of Pages
105-113
Date Published
12/2017
ISSN Number
1532-821X
DOI
10.1016/j.apmr.2016.09.118
Alternate Journal
Arch Phys Med Rehabil
PMID
27742450
PMCID
PMC5183499
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