Phantom Pain, Residual Limb Pain, and Back Pain in Amputees: Results of a National Survey

Ephraim, Patti L.; Wegener, Stephen T.; MacKenzie, Ellen J.; Dillingham, Timothy R.; Pezzin, Liliana E.

doi:10.1016/j.apmr.2005.03.031

Cited by 584 publications

(570 citation statements)

References 34 publications

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“…The time since amputation was relatively short, since we could only invite patients who were registered with the diagnosis of FPHAs since 2002. However, in previous studies, there was inconclusive evidence regarding the influence of the time since amputation on the development of MSCs [11,12]. Furthermore, the heterogeneity of the amputation levels, especially the partial hand amputations, complicates generalisability of the results to the general FPHAs population.…”

Section: Strengths and Limitationsmentioning

confidence: 98%

“…A prevalence of MSCs in the preceding year in individuals with major ULA (wrist disarticulation or more proximal amputation levels) of 65%, versus a year prevalence of 34% in the control group, was found recently [13]. However, there is inconclusive evidence regarding the factors that may contribute to the development of MSCs, such as level of amputation and time since amputation [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…In individuals with upper limb absence (ULA), congenital or acquired, the prevalence of musculoskeletal complaints (MSCs) of their residual limb, non-affected limb, neck, or back ranges from 20% to 64%, depending on the location of MSCs [1,6,[9][10][11][12]. A prevalence of MSCs in the preceding year in individuals with major ULA (wrist disarticulation or more proximal amputation levels) of 65%, versus a year prevalence of 34% in the control group, was found recently [13].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Musculoskeletal complaints in individuals with finger or partial hand amputations in the Netherlands: a cross-sectional study

Bouma

Postema

Bongers

et al. 2017

Disability and Rehabilitation

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Purpose: To compare the prevalence of musculoskeletal complaints (MSCs) in individuals with finger or partial hand amputations (FPHAs) with a control group and to explore the effect and predictors of MSCs in individuals with FPHAs. Method: A questionnaire-based cross-sectional study was conducted. The primary outcome measures were: prevalence of MSCs, health status, pain-related disability, physical work demands, work productivity, and hand function. Results: The response rate was 61%. A comparable proportion of individuals with FPHAs (n ¼ 99) and controls (n ¼ 102) reported MSCs in the preceding 4 weeks (33% vs. 28%, respectively) or in the preceding year (37% vs. 33%, respectively). Individuals with FPHAs with MSCs experienced more pain than controls with MSCs. Regular occurrence of stump sensations and self-reported limited range of motion (ROM) of the wrist of the affected limb were predictors for MSCs in individuals with FPHAs. Conclusions: The prevalence of MSCs was comparable in individuals with FPHAs and controls. However, clinicians should pay special attention to the risk of developing MSCs in patients with stump sensations and limited ROM of the wrist of the affected limb. Future research should focus on the role of wrist movements and compensatory movements in the development of MSCs in individuals with FPHAs. ä IMPLICATIONS FOR REHABILITATIONThe prevalence of musculoskeletal complaints (MSCs) in individuals with finger or partial hand amputations (FPHAs) and control subjects was similar. Regular occurrence of stump sensations and limited range of motion of the wrist of the affected limb were predictors of developing MSCs in individuals with FPHAs. Clinicians should pay special attention to individuals with FPHAs with the presence of these predictors of developing MSCs. For a better understanding of the development of and treatment options for MSCs, future research focusing on the role of wrist function in the development of MSCs in individuals with FPHAs is necessary. ARTICLE HISTORY

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Section: Strengths and Limitationsmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Musculoskeletal complaints in individuals with finger or partial hand amputations in the Netherlands: a cross-sectional study

Bouma

Postema

Bongers

et al. 2017

Disability and Rehabilitation

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“…While phantom limb pain is a well-recognized phenomenon [5], clinical experience has suggested that the augmentation of phantom limb pain with visceral stimulation is an issue for many military personnel with amputation (visceral stimulation being the sensation of the bowel or bladder either filling or evacuating). However, the prevalence of this phenomenon is not known.…”

Section: Introductionmentioning

confidence: 99%

Cross-sectional study of alteration of phantom limb pain with visceral stimulation in military personnel with amputation

Rafferty¹,

Bennett²,

Britton³

et al. 2015

J Rehabil Res Dev

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Abstract-While phantom limb pain is a well-recognized phenomenon, clinical experience has suggested that the augmentation of phantom limb pain with visceral stimulation is an issue for many military personnel with amputation (visceral stimulation being the sensation of the bowel or bladder either filling or evacuating). However, the prevalence of this phenomenon is not known. The aim of this study was to investigate the prevalence of the alteration in phantom limb pain and the effect that visceral stimulation has on phantom limb pain intensity. A crosssectional study of 75 military personnel who have lost one or both lower limbs completed a questionnaire to assess the prevalence of the alteration of phantom limb pain with visceral stimulation. Included in the questionnaire was a pain visual analog scale (VAS) graded from 0 to 10. Patients recorded the presence and intensity of phantom limb pain. They also recorded whether and how this pain altered with a need to micturate or micturition, and/or a need to defecate or defecation, again using a pain VAS. Time since amputation, level of amputation, and medications were also recorded. Patients reported a phantom limb pain prevalence of 85% with a mean VAS of 3.6. In all, 56% of patients reported a change in the severity of phantom limb pain with visceral stimuli. The mean increase in VAS for visceral stimulation was 2.5 +/-1.6 for bladder stimulation and 2.9 +/-2.0 for bowel stimulation. Of the patients questioned, 65% reported an improvement in symptoms over time. VAS scores were highest in the subgroup less than 6 mo postamputation. An increase in phantom limb pain with visceral stimulation is a common problem for military personnel with amputation.

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“…The amputee's reduced ability to modulate transverse plane joint torque, a turning mechanism for nonamputees [27], and lack of rotational compliance at the socket-pylon interface may contribute to excessive residual limb shear forces that lead to skin breakdown and residual limb pain. This type of pain continues to be a common problem for lower limb amputees and can lead to limitations in both physical and physiological function [13]. A torsion adapter is a prosthetic component designed to facilitate transverse plane rotation in the range that exists during nonamputee gait, resulting in decreased torque transferred through the prosthetic socket to the residual limb [21].…”

Section: Introductionmentioning

confidence: 99%

Does a Torsion Adapter Improve Functional Mobility, Pain, and Fatigue in Patients with Transtibial Amputation?

Segal

Kracht

Klute

2014

Clinical Orthopaedics &Amp; Related Research

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Background Turning gait is an integral part of daily ambulation and likely poses a greater challenge for patients with transtibial amputation compared with walking a straight pathway. A torsion adapter is a prosthetic component that can increase transverse plane compliance of the prosthesis and decrease the torque applied to the residual limb, but whether this will improve patients' mobility, pain, and fatigue remains unknown.Questions/purposes Does prescription of a torsion adapter translate to improvements in (1) functional mobility and (2) self-perceived pain and fatigue in moderately active patients with lower limb amputation? Methods Ten unilateral transtibial amputees wore a torsion or rigid adapter in random order. Functional mobility was assessed through a field measurement using an activity monitor and through a laboratory measurement using a 6-minute walk test that included turns. The residual limb pain grade assessed self-perceived pain and the Multidimensional Fatigue Inventory assessed fatigue. Results We found relatively small functional differences for amputees wearing a torsion adapter versus a rigid adapter. Amputees wearing a torsion adapter tended to take more low-and medium-intensity steps per day (331 ± 365 and 437 ± 511 difference in steps; effect size = 0.44 and 0.17; confidence interval [CI], 70-592 and 71-802; p = 0.019 and 0.024, respectively). They also experienced less pain interference with activities (1.9 ± 1.7 change in score; effect size = 0.83; CI, 0.3-3.4; p = 0.026) when wearing a torsion adapter. However, these patients took a similar number of total steps per day, walked a comparable distance in 6 minutes, and reported similar residual limb pain and fatigue. Conclusions For a moderately active group of amputees, the torsion adapter did not translate to substantial improvements in functional mobility and self-perceived pain and fatigue. The small increases in low-and mediumintensity activities with less pain interference when wearing a torsion adapter provides evidence to support prescribing this device for amputees with difficulty navigating the household and community environments. Level of Evidence Level II, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

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Phantom Pain, Residual Limb Pain, and Back Pain in Amputees: Results of a National Survey

Cited by 584 publications

References 34 publications

Musculoskeletal complaints in individuals with finger or partial hand amputations in the Netherlands: a cross-sectional study

Musculoskeletal complaints in individuals with finger or partial hand amputations in the Netherlands: a cross-sectional study

Cross-sectional study of alteration of phantom limb pain with visceral stimulation in military personnel with amputation

Does a Torsion Adapter Improve Functional Mobility, Pain, and Fatigue in Patients with Transtibial Amputation?

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