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

Published:October 11, 2016DOI:https://doi.org/10.1016/j.apmr.2016.09.118

      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.

      Keywords

      List of abbreviations:

      LLA (lower limb amputation), PLP (phantom limb pain), PROMIS (Patient-Reported Outcomes Measurement Information System), RLP (residual limb pain)
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