Physical activity and lower-back pain in persons with traumatic transfemoral amputation: A national cross-sectional survey

Abstract

Abstract-Lower-back pain (LBP) is a common secondary condition following lower-limb amputation. The purpose of this study was to investigate LBP prevalence and the relationship between LBP and physical activity (PA) levels in a national sample of persons with traumatic transfemoral amputation (TFA). Questionnaires were mailed to a random sample of people with traumatic TFA (n = 322) from the New Zealand Artificial Limb Board national database. Of the participants who completed the survey (55% response rate), 64.1% reported LBP and 39.1% reported restricted PA due to LBP. There was no relationship between the PA levels of persons with and without LBP (chi-square = 2.11, p > 0.05). There was an equal distribution of persons with LBP in low, medium, and high PA subgroups. However, persons who reported restricted PA due to LBP had lower PA scores than persons with LBP and no restricted PA (chi-square = 11.56, p < 0.05). Based on our results, LBP is prevalent in the traumatic TFA population. PA levels are not influenced by the presence or absence of LBP. However, future studies investigating LBP coping strategies and using objective PA outcome measures might further elucidate the relationship between PA and LBP in this population.

Outcome of Percutaneous Osseointegrated Prostheses for Patients With Unilateral Transfemoral Amputation at Two-Year Follow-Up

“…Pain of this kind has frequently been described as bothersome to individuals with amputations. 6,[33][34][35][36] Other items not rated as being changed related to maintaining residual limb hygiene and residual limb appearance. This shows that the daily cleaning of the implant-skin penetration area and the protruding screw sticking out of the limb are not reported as troublesome after treatment.…”

Exploring Factors Influencing Low Back Pain in People With Nondysvascular Lower Limb Amputation: A National Survey

“…Based on the Dillman sample size formula [22], 295 participants were required with nondysvascular TFA and TTA in New Zealand, assuming a 95% confidence level and a 50/50 split for choosing a “yes” or “no” response to the LBP question. Given that a recent national survey of the same population had a 56% response rate [3], and that people with TTA are twice as common as those with TFA [23], it was estimated that 526 surveys would need to be distributed to potential participants.…”

“…Low back pain (LBP) is a common musculoskeletal impairment affecting between 50% and 80% of people with transfemoral amputation (TFA) and transtibial amputation (TTA) [1‐3]. Although some prevalence studies report that people with TFA experience more LBP than those with TTA [1,4], other studies show no differences [2,5].…”

Spinal, pelvic, and hip movement asymmetries in people with lower-limb amputation: Systematic review

“…Evidence from prevalence studies confirm that LBP is reported as "more bothersome" than other comorbid conditions such as phantom limb pain and osteoarthritis [16][17]. Further, a majority of respondents with LBP consistently report the presence of LBP for more than 3 yr, which suggests the chronic ongoing nature of LBP in this population [15]. * Potential biomechanical contributing factors for ongoing LBP in this population include proximal movement asymmetries at the trunk and lumbopelvic segments secondary to walking with a prosthesis [12].…”

“…LBP is a common musculoskeletal condition following lower-limb amputation [14][15]. Evidence from prevalence studies confirm that LBP is reported as "more bothersome" than other comorbid conditions such as phantom limb pain and osteoarthritis [16][17].…”