Pain and Health-Related Quality of Life in War Veterans with Bilateral Lower Limb Amputations

Rahimi, Abolfazl; Mousavi, Batool; Soroush, Mohammadreza; Masumi, M; Montazeri, Ali

doi:10.5812/traumamon.5135

Cited by 23 publications

(55 citation statements)

References 26 publications

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“…It seems that other factors such as sedentary life style are more effective in weight and related metabolic abnormalities than the quality of life in this group of individuals [9, 10]. In previous studies poorer HRQOL in lower limb amputees have been revealed in comparison with general population [3, 33–35]. Indeed, physical inactivity caused by amputation could affect the quality of life in amputees.…”

Section: Discussionmentioning

confidence: 99%

“…However, there are limited studies concerning the evaluation of HRQOL in amputees according to their metabolic disorders. Different factors including pain, depression, social supports, prosthesis problems and social activity participation may have effect on HRQOL in amputees [3, 36]. The relatively no association between Mets and HRQOL is found in veterans with bilateral lower limb amputations.…”

Section: Discussionmentioning

confidence: 99%

“…The relatively no association between Mets and HRQOL is found in veterans with bilateral lower limb amputations. Therefore, we conclude that although having the major disabily could be strong enough to cause poor quality of life [3], poor quality of life alone could not be associated with health burden in this population. The association of metabolic abnormalities with HRQOL has been assessed in previous studies.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of metabolic syndrome and health-related quality of life in war-related bilateral lower limb amputees

Ejtahed

Soroush

Hasani‐Ranjbar

et al. 2017

J Diabetes Metab Disord

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BackgroundLower limb amputation is correlated with considerable impairments in health-related quality of life (HRQOL) in veterans. The aim of this study is to determine the prevalence of metabolic syndrome (MetS) in veterans with bilateral lower limb amputation and to identify its association with HRQOL.MethodsThis cross-sectional study was conducted on 235 Iranian male veterans with bilateral lower limb amputation. Demographics, anthropometrics, and biochemical measurements were assessed and MetS was defined by National Cholesterol Education Program Adult Treatment Panel III definition. HRQOL was assessed using the 36-item Short Form Health Survey (SF-36) questionnaire which measures eight health-related domains. The scores were compared between two groups of bilateral lower limb Amputees who have diagnosed with and without MetS.ResultsThe response rate was 40.7% and the mean age of the amputees was 52.05 years. 62.1% of participants were suffering from MetS (95% CI: 55.9%–68.4%). Patients with MetS were observed to have higher weight, waist and hip circumferences, FBS, TG, LDL and liver enzymes concentrations (P < 0.05). Although scores on all 8 subscales of SF-36 were low, no significant difference was observed in HRQOL scores between amputees with and without MetS. Moreover, the risk of MetS was not significantly different across subjects in the highest compared to the lowest quartile category of HRQOL scores.ConclusionsPrevalence of MetS in veterans with bilateral lower limb amputation was higher and their HRQOL was lower compared to general population. Some strategies are needed to reduce the risk of cardiovascular diseases among this susceptible population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prevalence of metabolic syndrome and health-related quality of life in war-related bilateral lower limb amputees

Ejtahed

Soroush

Hasani‐Ranjbar

et al. 2017

J Diabetes Metab Disord

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“…Of the 21 epidemiology studies of amputees included in the review, eight had a longitudinal design [98][99][100][101][102][103][104][105] and 13 had a cross-sectional design. 9,10,[106][107][108][109][110][111][112][113][114][115][116] Longitudinal studies Table 21 shows the characteristics of the populations in the longitudinal studies. Six studies had a prospective design 98,100,102-105 and two were retrospective.…”

Section: Epidemiology Studiesmentioning

confidence: 99%

Brain and spinal stimulation therapies for phantom limb pain: a systematic review

Corbett

South

Harden

et al. 2018

Health Technol Assess

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Background Although many treatments exist for phantom limb pain (PLP), the evidence supporting them is limited and there are no guidelines for PLP management. Brain and spinal cord neurostimulation therapies are targeted at patients with chronic PLP but have yet to be systematically reviewed. Objective To determine which types of brain and spinal stimulation therapy appear to be the best for treating chronic PLP. Design Systematic reviews of effectiveness and epidemiology studies, and a survey of NHS practice. Population All patients with PLP. Interventions Invasive interventions – deep brain stimulation (DBS), motor cortex stimulation (MCS), spinal cord stimulation (SCS) and dorsal root ganglion (DRG) stimulation. Non-invasive interventions – repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). Main outcome measures Phantom limb pain and quality of life. Data sources Twelve databases (including MEDLINE and EMBASE) and clinical trial registries were searched in May 2017, with no date limits applied. Review methods Two reviewers screened titles and abstracts and full texts. Data extraction and quality assessments were undertaken by one reviewer and checked by another. A questionnaire was distributed to clinicians via established e-mail lists of two relevant clinical societies. All results were presented narratively with accompanying tables. Results Seven randomised controlled trials (RCTs), 30 non-comparative group studies, 18 case reports and 21 epidemiology studies were included. Results from a good-quality RCT suggested short-term benefits of rTMS in reducing PLP, but not in reducing anxiety or depression. Small randomised trials of tDCS suggested the possibility of modest, short-term reductions in PLP. No RCTs of invasive therapies were identified. Results from small, non-comparative group studies suggested that, although many patients benefited from short-term pain reduction, far fewer maintained their benefits. Most studies had important methodological or reporting limitations and few studies reported quality-of-life data. The evidence on prognostic factors for the development of chronic PLP from the longitudinal studies also had important limitations. The results from these studies suggested that pre-amputation pain and early PLP intensity are good predictors of chronic PLP. Results from the cross-sectional studies suggested that the proportion of patients with severe chronic PLP is between around 30% and 40% of the chronic PLP population, and that around one-quarter of chronic PLP patients find their PLP to be either moderately or severely limiting or bothersome. There were 37 responses to the questionnaire distributed to clinicians. SCS and DRG stimulation are frequently used in the NHS but the prevalence of use of DBS and MCS was low. Most responders considered SCS and DRG stimulation to be at least sometimes effective. Neurosurgeons had mixed views on DBS, but most considered MCS to rarely be effective. Most clinicians thought that a randomised trial design could be successfully used to study neurostimulation therapies. Limitation There was a lack of robust research studies. Conclusions Currently available studies of the efficacy, effectiveness and safety of neurostimulation treatments do not provide robust, reliable results. Therefore, it is uncertain which treatments are best for chronic PLP. Future work Randomised crossover trials, randomised N-of-1 trials and prospective registry trials are viable study designs for future research. Study registration The study is registered as PROSPERO CRD42017065387. Funding The National Institute for Health Research Health Technology Assessment programme.

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“…However, the scope of such disorders may expand months or even years after the trauma [1]. The quality of life, independence in daily activities, and overall satisfaction of life may be decreased in military and civilian veterans due to war-related traumas [2]. Furthermore, the aforementioned sequelae may cause psychological disorders in victims.…”

Section: Introductionmentioning

confidence: 99%

Assessment of orthotic needs in Iranian veterans with ankle and foot disorders

2018

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BackgroundWar-related traumas can lead to orthopedic and neurological disorders in victims. However, the scope of such disorders may expand months or even years after the trauma. Orthotic treatment as a rehabilitation process aims to enable people with disabilities to reach and maintain their optimal physical, sensory, intellectual, psychological, and social functional levels. This study aimed to investigate the rate of using orthoses among Iranian veterans with neuromuscular and skeletal disorders of the ankle and foot. Furthermore, the priorities of orthotic treatment in those veterans were explored.MethodsThis qualitative study was a national health needs assessment conducted in 11 provinces of Iran during 2011–2016. A stakeholder research group was established to survey the veterans in respect to their demographic variables, activities of daily living, current health conditions, and rate of using orthoses.ResultsOverall, 907 of the 1124 veteran participants completed the survey (response rate: 80.7%). Most of the veterans were men (97.7%), and their age and disability rate were 52.07 ± 8.13 years and 31.92% ± 14.93%, respectively. Nearly 42% of the veterans had experience in using orthoses on a daily and weekly basis. As physical ambulation was the main problematic activity in veterans, most of them were using medical shoes and foot orthoses. Nearly 37% of veterans were in need of some type of lower limb orthoses on the contralateral side to compensate for their hip inequality. In sequential order, the most in need orthoses for veterans were foot orthoses (n = 538), medical shoes (n = 447), lower limb orthoses on the contralateral side (n = 320), spinal orthoses (n = 273), and upper limb orthoses (n = 86).ConclusionsIn spite of the high demands for orthoses among Iranian veterans with ankle and foot disorders, the use of orthoses is insufficient. Hence, there is a discrepancy between the current rate of orthoses use and its ideal situation, and more resources should be provided for service providers to be able to serve veterans. Moreover, veterans should be educated regarding orthoses, their use, and their impacts on the user’s health status. The findings of a needs assessment of orthoses can be used in strategic planning and decision making to improve health care services for Iranian veterans.

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Pain and Health-Related Quality of Life in War Veterans with Bilateral Lower Limb Amputations

Cited by 23 publications

References 26 publications

Prevalence of metabolic syndrome and health-related quality of life in war-related bilateral lower limb amputees

Prevalence of metabolic syndrome and health-related quality of life in war-related bilateral lower limb amputees

Brain and spinal stimulation therapies for phantom limb pain: a systematic review

Assessment of orthotic needs in Iranian veterans with ankle and foot disorders

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