Article

Chronic low back pain (LBP) is a common musculoskeletal impairment in
people with lower limb amputation. Given the multifactorial nature of LBP,
exploring the factors influencing the presence and intensity of LBP is warranted.
OBJECTIVE: To investigate which physical, personal, and amputee-specific factors
predicted the presence and intensity of LBP in persons with nondysvascular
transfemoral amputation (TFA) and transtibial amputation (TTA). DESIGN: A retrospective cross-sectional survey. SETTING: A national random sample of people
with nondysvascular TFA and TTA. PARTICIPANTS: Participants (N = 526) with
unilateral TFA and TTA due to nondysvascular etiology (ie, trauma, tumors, and
congenital causes) and a minimum prosthesis use of 1 year since amputation were
invited to participate in the survey. The data from 208 participants (43.4%
response rate) were used for multivariate regression analysis. METHODS
(INDEPENDENT VARIABLES): Personal (ie, age, body mass, gender, work status, and
presence of comorbid conditions), amputee-specific (ie, level of amputation,
years of prosthesis use, presence of phantom-limb pain, residual-limb problems,
and nonamputated limb pain), and physical factors (ie, pain-provoking postures
including standing, bending, lifting, walking, sitting, sit-to-stand, and
climbing stairs). MAIN OUTCOME MEASURES (DEPENDENT VARIABLES): LBP presence and
intensity. RESULTS: A multivariate logistic regression model showed that the
presence of 2 or more comorbid conditions (prevalence odds ratio [POR] = 4.34, P
= .01), residual-limb problems (POR = 3.76, P < .01), and phantom-limb pain (POR
= 2.46, P = .01) influenced the presence of LBP. Given the high LBP prevalence
(63%) in the study, there is a tendency for overestimation of POR, and the
results must be interpreted with caution. In those with LBP, the presence of
residual-limb problems (beta = 0.21, P = .01) and experiencing LBP symptoms
during sit-to-stand task (beta = 0.22, P = .03) were positively associated with
LBP intensity, whereas being employed demonstrated a negative association (beta =
-0.18, P = .03) in the multivariate linear regression model. CONCLUSIONS:
Rehabilitation professionals should be cognizant of the influence that comorbid
conditions, residual-limb problems, and phantom pain have on the presence of LBP
in people with nondysvascular lower limb amputation. Further prospective studies
could investigate the underlying causal mechanisms of LBP. LEVEL OF EVIDENCE: II.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS