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Johansson R, Jensen L, Barnett CT, Rusaw DF. Quantitative methods used to evaluate balance, postural control, and the fear of falling in lower limb prosthesis users: A systematic review. Prosthet Orthot Int 2023; 47:586-598. [PMID: 37318276 DOI: 10.1097/pxr.0000000000000250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 04/23/2023] [Indexed: 06/16/2023]
Abstract
Problems with balance, postural control, and fear of falling are highly prevalent in lower limb prosthesis users, with much research conducted to understand these issues. The variety of tools used to assess these concepts presents a challenge when interpreting research outcomes. This systematic review aimed to provide a synthesis of quantifiable methods used in the evaluation of balance, postural control, and fear of falling in lower limb prosthesis users with an amputation level at or proximal to the ankle joint. A systematic search was conducted in CINAHL, Medline, AMED, Cochrane, AgeLine, Scopus, Web of Science, Proquest, PsycINFO, PsycArticles, and PubPsych databases followed by additional manual searching via reference lists in the reviewed articles databases. Included articles used quantitative measure of balance or postural control as one of the dependent variables, lower limb prosthesis users as a sample group, and were published in a peer-reviewed journal in English. Relevant assessment questions were created by the investigators to rate the assessment methods used in the individual studies. Descriptive and summary statistics are used to synthesize the results. The search yielded (n = 187) articles assessing balance or postural control (n = 5487 persons in total) and (n = 66) articles assessing fear of falling or balance confidence (n = 7325 persons in total). The most used test to measure balance was the Berg Balance Scale and the most used test to measure fear of falling was the Activities-specific Balance Confidence scale. A large number of studies did not present if the chosen methods were valid and reliable for the lower limb prosthesis users. Among study limitations, small sample size was common.
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Affiliation(s)
- Robin Johansson
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Louise Jensen
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Southern Älvsborg Hospital, Borås, Sweden
| | - Cleveland T Barnett
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - David F Rusaw
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Bekrater-Bodmann R, Kehl I, Hafner BJ, Ranker A, Giordano A, Franchignoni F. Rasch validation of the German translation of the Prosthetic Limb Users Survey of Mobility short forms in people with lower limb amputation. Prosthet Orthot Int 2023; 47:552-557. [PMID: 36689667 DOI: 10.1097/pxr.0000000000000201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/19/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Prostheses are a primary rehabilitative intervention for people after lower limb amputation. To appropriately measure the effectiveness of prosthetic interventions, valid and reliable measures of prosthetic mobility are required. The Prosthetic Limb Users Survey of Mobility (PLUS-M) is a promising instrument for measuring prosthesis users' mobility. However, German translations of the PLUS-M short forms have not yet been validated. OBJECTIVES Rasch validation of the German translation of the PLUS-M short forms in people with lower limb amputation. STUDY DESIGN This study is based on a cross-sectional survey of prosthesis-using lower limb amputees from a nation-wide cohort. METHODS PLUS-M data (the 7-item and the 12-item shortforms; PLUS-M-7 and PLUS-M-12, respectively) from 194 lower limb prosthesis users were subjected to Rasch analysis, an advanced statistical method for assessing if the measurement properties of a questionnaire comply with a wide spectrum of psychometric requirements. RESULTS Analysis showed appropriate rating scale functioning, good internal construct validity (item fit), unidimensionality, and good targeting of the PLUS-M-7 and PLUS-M-12 short forms. Moreover, the greater conditional measurement precision of PLUS-M-12 (regarding higher test information and lower standard error of mobility estimates) was quantified. CONCLUSIONS Rasch analysis of the German translation of both PLUS-M short forms showed good psychometric qualities. In addition, our study showed that test scores from the PLUS-M-12 are more accurate. Therefore, the PLUS-M-12 is recommended for individual-level clinical applications (e.g., classification or change assessment).
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Affiliation(s)
- Robin Bekrater-Bodmann
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Isabelle Kehl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Brian J Hafner
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Alexander Ranker
- Department of Rehabilitation Medicine, Hannover Medical School, Hannover, Germany
| | - Andrea Giordano
- Bioengineering Unit, Scientific Institute of Veruno, Istituti Clinici Scientifici Maugeri IRCCS, Veruno (NO), Italy
| | - Franco Franchignoni
- Physical and Rehabilitation Medicine Unit, Scientific Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Tradate (VA), Italy
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Bajracharya AR, Seng-iad S, Sasaki K, Guerra G. Cross-Cultural Adaptation and Validation of The Nepali Version of The Prosthetic Limb Users Survey of Mobility Short-Form (Plus-M™/Nepali-12Sf) In Lower Limb Prosthesis Users. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 2023; 6:41310. [PMID: 38873005 PMCID: PMC11168605 DOI: 10.33137/cpoj.v6i1.41310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/12/2023] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Objective mobility measurement of Nepali prosthesis users is lacking. OBJECTIVE The objective of this study was to cross-culturally adapt, translate and evaluate construct validity of the Prosthetic Limb Users Survey of Mobility (PLUS-M™/Nepali-12 Short Form (SF)) instrument in lower limb prosthesis users residing in Nepal. METHODOLOGY Two forward translations, review and reconciliation, back translation, expert review, developer review to create the PLUS-M™/Nepali-12SF. Psychometric testing for internal consistency, test-retest reliability and construct validity against the Two-Minute Walk Test (2MWT) and Amputee Mobility Predictor with Prosthesis (AMPPRO) were performed on sixty-six lower limb prosthesis users. FINDINGS The majority of populations were with transtibial amputation 45 (68%), with transfemoral amputation 15 (23%), with knee disarticulation 5 (7.5%) and with syme's amputation 1 (1.5%). The most common cause of amputation among the population was trauma and the least was tumor. Chronbach's alpha for the PLUS-M™/Nepali-12SF was 0.90, mean T-Score was 52.90, test-retest intraclass correlation coefficient (ICC) was 0.94 (95% confidence interval 0.90-0.96). Construct validity with the 2MWT was good (r = 0.62, p< 0.001) and moderately positive with the AMPPRO (r = 0.57, p< 0.001). CONCLUSION Our research evidenced that the PLUS-M™/Nepali-12SF had excellent reproducibility. The significance of this work is that it may allow for the measurement of mobility in austere locations of Nepal.
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Affiliation(s)
- AR Bajracharya
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - S Seng-iad
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - K Sasaki
- Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - G Guerra
- Department of Exercise and Sport Science, St. Mary's University, San Antonio, Texas, 78210, USA
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Yosmaoglu S, Yazicioglu G, Demir Y, Aydemir K, Yosmaoğlu HB. Validity and reliability of Turkish transcultural adaptation of the Prosthetic Limb Users Survey of Mobility. Prosthet Orthot Int 2023; 47:189-193. [PMID: 36037291 DOI: 10.1097/pxr.0000000000000177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 06/01/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Amputee-specific, self-assessment mobility scales are essential to evaluate mobility in lower-limb amputees. OBJECTIVES To evaluate the validity and reliability of a Turkish translation and adaptation of the Prosthetic Limb Users Survey of Mobility. STUDY DESIGN This is a validation study. METHODS Turkish translation of the Prosthetic Limb Users Survey of Mobility (PLUS-M-T) from its original was performed following the rules of intercultural adaptation and translation methods. The PLUS-M-T and its 12-item short form were applied to '100 induviduals with limb loss twice in 3-day intervals. The structural validity analysis was determined by calculating the correlation with the Amputee Mobility Scale, which is a valid, reliable scale for assessing the functional level in amputees. The Cronbach alpha coefficient was calculated to analyze the internal consistency. The interclass correlation coefficient (ICC) and Spearman correlation coefficient (r) were calculated, and the test-retest reliability was determined. RESULTS A positive, high correlation was found between the first application and its repetition of both PLUS-M-T (ICC = 0.85, r = 0.94, P < 0.001) and 12-item short form (ICC = 0.92, r = 0.93, P < 0.001). The internal consistency was high for both PLUS-M-T (Cronbach alpha = 0.94) and 12-item short form (Cronbach alpha = 0.91). A positive, high correlation was found between the scores obtained from the Amputee Mobility Scale and PLUS-M-T (r = 0.84, P < 0.001) and 12 question short form (r = 0.77, P < 0.001). CONCLUSION Turkish translation of the PLUS-M questionnaire is a valid and reliable scale for assessing the mobility of individuals who have undergone lower-extremity amputation using a prosthesis.
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Affiliation(s)
- Sevgin Yosmaoglu
- Department of Physical Medicine and Rehabilitation, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Gul Yazicioglu
- Faculty of Physiotherapy, Hacettepe University, Ankara, Turkey
| | - Yasin Demir
- Department of Physical Medicine and Rehabilitation, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Koray Aydemir
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gülhane Faculty of Medicine, Gaziler Physical Therapy and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Hayri Baran Yosmaoğlu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Baskent University, Ankara, Turkey
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Tan JM, Halford GRJ, Lukin M, Kohler F. Recommendations from the ISPO lower-limb COMPASS: Patient-reported and performance-based outcome measures. Prosthet Orthot Int 2023; 47:13-25. [PMID: 36629556 PMCID: PMC9945573 DOI: 10.1097/pxr.0000000000000197] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 08/01/2022] [Accepted: 09/08/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Outcome measures (patient-reported and performance-based) are used widely but not uniformly within the clinical setting for individuals with lower-limb absence (LLA). The need for more detailed information by funding bodies, service planners and providers, and researchers requires the systematic and routine use of outcome measures. Currently, there is no consensus on which outcome measure(s) should be used for individuals with LLA. The aim of the International Society of Prosthetics and Orthotics (ISPO) lower-limb Consensus Outcome Measures for Prosthetic and Amputation Services (COMPASS) was to produce a recommended list of outcome measures to be actively promoted for routine use within clinical practice before and after an episode of care. METHODS Between May and June 2021, 46 users, clinicians, researchers, managers, and policymakers working in the field of LLA and prosthetic users met virtually. Consensus participants were first asked to complete an online survey with questions based on the results from a systematic review and the outcomes from an expert panel. A modified Delphi technique was used to determine outcome measures for use in routine clinical practice. This paper discusses the ISPO lower-limb COMPASS process from which recommendations were made. RESULTS The ISPO lower-limb COMPASS resulted in the following 6 recommendations: (1) Amputee Mobility Predictor, Timed Up and Go, Two-Minute Walk Test, Prosthetic Evaluation Questionnaire-Residual Limb Health, Prosthetic Evaluation Questionnaire-Utility, and Trinity Amputation and Prosthesis Experience Scales-Revised, which make up the ISPO lower-limb COMPASS ; (2) Comprehensive High-Level Activity Mobility Predictor and Six-Minute Walk Test are 2 additional outcome measures recommended for higher-activity-level individuals with LLA, which make up the COMPASS+ ; (3) Patient-Specific Function Scale makes up the COMPASS Adjunct ; (4) a generic health-related quality of life outcome measure such as the European Quality of Life-5D-5L or Patient-Reported Outcomes Measurement Information System-29 item can be used to supplement the COMPASS; (5) outcome measures suited to low- and middle-income countries need to be developed with a focus on activities such as sitting cross-legged, kneeling, squatting, and other culturally important mobility-related activities; and (6) translation, validation, and open sharing of translated outcome measures included in the COMPASS, COMPASS+, and COMPASS Adjunct occurs. CONCLUSION The above recommendations represent the current status of knowledge on outcome measures for LLA based on research and international consensus and hence, will change over time. This work has been developed for clinicians and researchers to improve knowledge on outcome measures to guide clinical decision-making and future research initiatives.
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Affiliation(s)
- Jade M. Tan
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- School of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Gregory R. J. Halford
- School of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- International Society of Prosthetics and Orthotics (ISPO), Copenhagen, Denmark
| | - Martina Lukin
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- School of Physiotherapy, Podiatry, Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- International Society of Prosthetics and Orthotics (ISPO), Copenhagen, Denmark
- School of Clinical Medicine, Medicine & Health, University of New South Wales, Sydney, Australia
- Clinical Directorate Aged Care and Rehabilitation, South Western Sydney Local Health District, Liverpool, Australia
- Rehabilitation Medicine, Braeside Hospital, Braeside Hospital, HammondCare Health, Sydney, Australia
| | - Friedbert Kohler
- School of Clinical Medicine, Medicine & Health, University of New South Wales, Sydney, Australia
- Clinical Directorate Aged Care and Rehabilitation, South Western Sydney Local Health District, Liverpool, Australia
- Rehabilitation Medicine, Braeside Hospital, Braeside Hospital, HammondCare Health, Sydney, Australia
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Balkman G, Samejima S, Fujimoto K, Hafner BJ. Japanese translation and linguistic validation of the Prosthetic Limb Users Survey of Mobility (PLUS-M). Prosthet Orthot Int 2022; 46:75-83. [PMID: 34693940 PMCID: PMC8857024 DOI: 10.1097/pxr.0000000000000059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/17/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Self-report survey instruments can be used to improve clinical care for lower-limb prosthesis users on a global scale by pooling comparable health outcomes data from multiple countries. The language translation process is critical to the quality and comparability of a translated survey instrument. OBJECTIVES The goals of this research were to translate the Prosthetic Limb Users Survey of Mobility (PLUS-M) item bank from English to Japanese using established guidelines, and linguistically validate the translated instrument by assessing its clarity, comprehension, and cultural applicability with Japanese prosthesis users. STUDY DESIGN Instrument translation and qualitative interviews. METHODS The translation process included two forward translations, reconciliation, backward translation, and review by clinical experts in Japan. Adult lower-limb prosthesis users participated in a linguistic validation study by responding to translated survey items and providing item-by-item feedback through cognitive interviews. RESULTS Following expert reviews, translated items were classified as grammatically and contextually unchanged (n = 21), minor revision required (n = 19), major revision required (n = 3), or removed (n = 1). Cognitive interviews with 10 participants indicated that additional revisions were required (n = 4). Items were revised and retested until it was determined that they were clear, well understood, and culturally applicable. CONCLUSIONS Use of a multistep translation and linguistic validation processes resulted in a linguistically comparable Japanese translation of the PLUS-M item bank. Japanese translations of the PLUS-M 7- and 12-item short forms were created for use in clinical practice and research. Availability of these linguistically comparable instruments is expected to facilitate opportunities for international comparison of prosthetic mobility data.
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Affiliation(s)
- Geoffrey Balkman
- Department of Rehabilitation Medicine, University of
Washington, Seattle, WA, USA
| | - Soshi Samejima
- Department of Rehabilitation Medicine, University of
Washington, Seattle, WA, USA
| | | | - Brian J. Hafner
- Department of Rehabilitation Medicine, University of
Washington, Seattle, WA, USA
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Andrysek J, Michelini A, Eshraghi A, Kheng S, Heang T, Thor P. Functional outcomes and user preferences of individuals with transfemoral amputations using two types of knee joints in under-resourced settings. Prosthet Orthot Int 2021; 45:463-469. [PMID: 34538819 DOI: 10.1097/pxr.0000000000000043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/27/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Information relating to prosthetic performance can inform clinical practice and improve patient outcomes in under-resourced countries. OBJECTIVES The main goal of this study was to compare functional outcomes and user preferences of individuals with transfemoral amputations using common types of knee joints in an under-resourced country. STUDY DESIGN Prospective, longitudinal, before and after trial. METHODS Twenty individuals with unilateral transfemoral amputations from a center in Cambodia transitioned from a commonly used single-axis manually locking knee International Committee of the Red Cross (ICRC) to a more advanced multiaxis knee joint with stance control All-Terrain Knee (ATK). Data were collected for the ICRC knee joint and the ATK immediately after fitting, after acclimation, and as part of a long-term follow-up. A timed walk test assessed walking distance and efficiency. Mobility and user-preferences were evaluated through questionnaires. RESULTS Distance during the timed walk test was significantly higher for the ATK compared with ICRC (P < 0.001), with functional gains retained at follow-up. No differences were found for gait efficiency and the mobility questionnaires. All participants, except one, preferred the ATK prosthesis. Benefits included greater knee stability and fewer perceived knee collapses; however, some disliked the appearance of the ATK. CONCLUSIONS The findings suggest positive outcomes with prosthetic services in under-resourced regions and the ICRC system, as well as the potential for improved functional outcomes with more advanced multiaxis knee components.
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Affiliation(s)
- Jan Andrysek
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Alexandria Michelini
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Arezoo Eshraghi
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Sisary Kheng
- Exceed Worldwide, Lisburn Square, Lisburn, United Kingdon
| | - Thearith Heang
- Exceed Worldwide, Lisburn Square, Lisburn, United Kingdon
| | - Phearsa Thor
- Exceed Worldwide, Lisburn Square, Lisburn, United Kingdon
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Karatzios C, Luthi F, Muff G, Benaim C. Complex regional pain syndrome of the residual limb in a transtibial lower-limb amputee: diagnosis and treatment. BMJ Case Rep 2021; 14:14/7/e239650. [PMID: 34301691 PMCID: PMC8311298 DOI: 10.1136/bcr-2020-239650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present the unusual case of complex regional pain syndrome (CRPS) of the residual limb in a 54-year-old woman with transtibial lower-limb amputation. Intractable pain developed 14 months after amputation, followed by successful rehabilitation. Anamnesis and clinical findings included sensory symptoms, vasomotor symptoms and signs, and oedema. The Budapest criteria for a diagnosis of CRPS were met. After infusions of bisphosphonates during a 5-week inpatient interdisciplinary rehabilitation programme, the pain decreased. Clinicians should suspect CRPS in case of chronic or recurrent residual limb pain. The Budapest criteria seem applicable even if interpretation of symptoms and findings can be complicated in vascular polymorbid lower-limb amputation. Bisphosphonates, proposed as first-line pharmacological treatment, can be useful.
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Affiliation(s)
- Christos Karatzios
- Department of Physical Medicine and Rehabilitation, Orthopaedic Hospital, Lausanne University Hospital, Lausanne, Switzerland
| | - Francois Luthi
- Department of Physical Medicine and Rehabilitation, Orthopaedic Hospital, Lausanne University Hospital, Lausanne, Switzerland.,Clinique Romande de Readaptation, Sion, Switzerland
| | - Guillaume Muff
- Department of Physical Medicine and Rehabilitation, Orthopaedic Hospital, Lausanne University Hospital, Lausanne, Switzerland
| | - Charles Benaim
- Department of Physical Medicine and Rehabilitation, Orthopaedic Hospital, Lausanne University Hospital, Lausanne, Switzerland.,Clinique Romande de Readaptation, Sion, Switzerland
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Wang Q, Chen C, Zhang S, Tang Y, Wang H, Zhou X, Wong MS. Pain issues in the victims with lower-limb amputation: 10 years after the 2008 Sichuan earthquake. Disabil Rehabil 2020; 44:1346-1353. [PMID: 32787698 DOI: 10.1080/09638288.2020.1803998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE To study the prevalence, intensity, and bothersomeness of amputation-related pain and further to identify the potential risk factors in the victims with lower-limb amputation 10 years after the 2008 Sichuan earthquake. METHODS In the cross-sectional study, 66 victims with lower-limb amputation were recruited. The Prostheses Evaluation Questionnaire was used to document the prevalence, intensity, and bothersomeness of amputation-related pain. The bivariate relationships between amputation-related pain and each of demographic characteristics were analyzed. RESULTS Majority of the enrolled lower-limb amputees (90.9%) reported to have one or more types of amputation-related pain. The intensity and bothersomeness of amputation-related pain were considered as severe in nearly 40% of these post-earthquake victims. The potential demographic risk factors associated with the prevalence, intensity, and bothersomeness of amputation-related pain were identified, including the age, lower level of education, marital status, employment, and comorbidity. CONCLUSIONS The pain coming from phantom limb, residual limb, non-amputated limb, and back was found persistent in the lower-limb amputees 10 years after the 2008 Sichuan earthquake. The findings of this study could provide useful reference for optimization of post-disaster rehabilitation strategies to alleviate chronic pain in the victims following lower-limb amputation.Implications for RehabilitationThe pain coming from phantom limb, residual limb, non-amputated limb, and back was found persistent in the victims with lower-limb amputation 10 years after the 2008 Sichuan earthquake.Continuous post-earthquake assessment and management of amputation-related pain should be taken into consideration for the victims with lower-limb amputation.The comorbidity should be effectively and efficiently controlled for the victims with lower-limb amputation due to its association with the intensity and bothersomeness of amputation-related pain.
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Affiliation(s)
- Qian Wang
- Center of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China.,Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Caiyun Chen
- Center of Comprehensive Service of Disabled, Deyang, China
| | - Sheng Zhang
- Center of Comprehensive Service of Disabled, Deyang, China
| | - Yiming Tang
- Center of Comprehensive Service of Disabled, Deyang, China
| | - Hongxia Wang
- Center of Comprehensive Service of Disabled, Deyang, China
| | - Xue Zhou
- Center of Comprehensive Service of Disabled, Deyang, China
| | - Man-Sang Wong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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