Exploring factors influencing low back pain in people with non-dysvascular lower limb amputation: a national survey
Background: 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 ampu...
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| Format: | Article |
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Elsevier
2017
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| Online Access: | https://eprints.nottingham.ac.uk/40815/ |
| _version_ | 1848796139583700992 |
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| author | Devan, Hemakumar Hendrick, Paul Hale, Leigh Carman, Allan Dillon, Michael Riberio, Dan |
| author_facet | Devan, Hemakumar Hendrick, Paul Hale, Leigh Carman, Allan Dillon, Michael Riberio, Dan |
| author_sort | Devan, Hemakumar |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background: 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 presence and intensity of low back pain (LBP) in persons with non-dysvascular transfemoral (TFA) and transtibial amputation (TTA).
Design: A retrospective cross-sectional survey.
Setting: A national random sample of people with non-dysvascular TFA and TTA.
Participants: Participants (N = 526) with unilateral TFA and TTA due to non-dysvascular aetiology (i.e. trauma, tumours, and congenital causes) and a minimum prosthesis usage of one 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 (i.e. age, body mass, gender, work status, and presence of comorbid conditions), amputee-specific (i.e. level of amputation, years of prosthesis use, presence of phantom limb pain, residual limb problems, and non-amputated limb pain), and physical factors (i.e. 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 two or more comorbid conditions (prevalence odds ratio (POR) = 4.34, p = .01), residual limb problems (POR 22 = 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 PORand 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, while being employed demonstrated a negative association (beta = - 0.18, p = .03) in the multivariate linear regression model.
Conclusions: Rehabilitation professionals should be cognisant of the influence that comorbid conditions, residual limb problems, and phantom pain have on the presence of LBP in people with non-dysvascular lower limb amputation. Further prospective studies could investigate the underlying causal mechanisms of LBP. |
| first_indexed | 2025-11-14T19:43:14Z |
| format | Article |
| id | nottingham-40815 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:43:14Z |
| publishDate | 2017 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-408152024-08-15T15:21:58Z https://eprints.nottingham.ac.uk/40815/ Exploring factors influencing low back pain in people with non-dysvascular lower limb amputation: a national survey Devan, Hemakumar Hendrick, Paul Hale, Leigh Carman, Allan Dillon, Michael Riberio, Dan Background: 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 presence and intensity of low back pain (LBP) in persons with non-dysvascular transfemoral (TFA) and transtibial amputation (TTA). Design: A retrospective cross-sectional survey. Setting: A national random sample of people with non-dysvascular TFA and TTA. Participants: Participants (N = 526) with unilateral TFA and TTA due to non-dysvascular aetiology (i.e. trauma, tumours, and congenital causes) and a minimum prosthesis usage of one 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 (i.e. age, body mass, gender, work status, and presence of comorbid conditions), amputee-specific (i.e. level of amputation, years of prosthesis use, presence of phantom limb pain, residual limb problems, and non-amputated limb pain), and physical factors (i.e. 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 two or more comorbid conditions (prevalence odds ratio (POR) = 4.34, p = .01), residual limb problems (POR 22 = 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 PORand 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, while being employed demonstrated a negative association (beta = - 0.18, p = .03) in the multivariate linear regression model. Conclusions: Rehabilitation professionals should be cognisant of the influence that comorbid conditions, residual limb problems, and phantom pain have on the presence of LBP in people with non-dysvascular lower limb amputation. Further prospective studies could investigate the underlying causal mechanisms of LBP. Elsevier 2017-02-15 Article PeerReviewed Devan, Hemakumar, Hendrick, Paul, Hale, Leigh, Carman, Allan, Dillon, Michael and Riberio, Dan (2017) Exploring factors influencing low back pain in people with non-dysvascular lower limb amputation: a national survey. PM&R, 9 (10). pp. 949-959. ISSN 1934-1482 activity cross-sectional low back pain musculoskeletal risk factors http://www.pmrjournal.org/article/S1934-1482(17)30175-2/abstract doi:10.1016/j.pmrj.2017.02.004 doi:10.1016/j.pmrj.2017.02.004 |
| spellingShingle | activity cross-sectional low back pain musculoskeletal risk factors Devan, Hemakumar Hendrick, Paul Hale, Leigh Carman, Allan Dillon, Michael Riberio, Dan Exploring factors influencing low back pain in people with non-dysvascular lower limb amputation: a national survey |
| title | Exploring factors influencing low back pain in people with non-dysvascular lower limb amputation: a national survey |
| title_full | Exploring factors influencing low back pain in people with non-dysvascular lower limb amputation: a national survey |
| title_fullStr | Exploring factors influencing low back pain in people with non-dysvascular lower limb amputation: a national survey |
| title_full_unstemmed | Exploring factors influencing low back pain in people with non-dysvascular lower limb amputation: a national survey |
| title_short | Exploring factors influencing low back pain in people with non-dysvascular lower limb amputation: a national survey |
| title_sort | exploring factors influencing low back pain in people with non-dysvascular lower limb amputation: a national survey |
| topic | activity cross-sectional low back pain musculoskeletal risk factors |
| url | https://eprints.nottingham.ac.uk/40815/ https://eprints.nottingham.ac.uk/40815/ https://eprints.nottingham.ac.uk/40815/ |