Abstract
Objectives
To evaluate whether tobacco use, alcohol consumption, and weight gain are associated
with the diagnosis of overuse musculoskeletal injuries within the first 12 months
after lower limb amputation.
Design
Retrospective cohort study.
Setting
Military treatment facilities.
Participants
Service members (N=681) with a deployment-related lower limb amputation.
Interventions
Not applicable.
Main Outcome Measures
Clinical diagnosis codes associated with musculoskeletal overuse injuries of the lower
limb, upper limb, and low back regions.
Results
In the first three months after amputation, tobacco use and alcohol consumption were
reported in 55.7% and 72.0%, respectively, of the retrospective sample. The overall
mean weight change was 22.9±23.6 pounds. The prevalence of reporting at least 1 overuse
injury within 4 to 12 months after amputation was 57.0% in the sample, with prevalence
rates of lower limb, upper limb and low back pain diagnoses at 28.3%, 21.7%, and 21.1%,
respectively. Service members reporting tobacco use in the first 3 months after amputation
were nearly twice as likely to be diagnosed with a lower limb musculoskeletal injury
4 to 12 months after amputation. Similarly, service members reporting alcohol consumption
within the first 3 months after amputation were more than twice as likely to be diagnosed
with at least 1 overuse musculoskeletal injury 4 to 12 months after amputation. However,
weight change or maximum weight after amputation were not associated with the diagnosis
of an overuse musculoskeletal injury.
Conclusions
Development of secondary overuse musculoskeletal injury appears to be related to tobacco
use and alcohol consumption, but not to weight gain. These findings warrant focused
research efforts toward developing preventive interventions.
Keywords
List of abbreviations:
DoD (Department of Defense), EMED (Expeditionary Medical Encounter Database), ICD-9 (International Classification of Diseases–9th Revision), ISS (Injury Severity Score), LBP (low back pain)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 20, 2020
Footnotes
Supported by the DoD-VA Extremity Trauma and Amputation Center of Excellence (work unit no. N1333).
The views expressed herein are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the U.S. Government.
Disclosures: none.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
