Low Back Pain in People With Lower Limb Amputation

Abstract

Study Design. A cross-sectional study based on an online questionnaire.Objective. The aim was to investigate the prevalence and intensity of low back pain (LBP) in people with lower limb amputation (LLA) and to analyze the association factors that can influence the genesis of LBP. Summary of Background Data. It is still unclear whether LBP is more prevalent in the amputated population than in its nonamputated counterpart. Given the multifactorial nature of LBP, it is necessary to explore possible factors that can influence its presence and intensity, to build a solid background to define a better rehabilitation pathway for the management of these people. Methods. The online questionnaire included six sections. informed consent of the study, demographic information, comorbid conditions, history of LLA, history of LBP, and acceptance of the amputation. Results. Between March and June 2021, 239 participants [mean age (SD). 49.2 (11.5); female 11%] completed the survey (response rate: 32%). From the results of this study, LBP in LLA showed a prevalence of 82% postamputation and 70% in the last year. A logistic regression with a backward method showed that participants who had problems in the not affected leg presented 1.58 (95% confidence interval: 0.70; 2.45) times higher odds to have LBP after the amputation. Conclusion. This study shows that the prevalence of LBP in lower limb amputees appears to be higher than in the general population, with similar levels of pain intensity and frequency. The highest percentage of people with a sedentary lifestyle not practicing any kind of sports emphasizes the importance of educating this population on the importance of physical activity. New strategies to invest in the education of this population in terms of physical activity are needed.

Exploring the Associations between the Biomechanical and Psychological Mechanistic Pathways of Lower Back Pain Development amongst Persons with Lower-Limb Amputation

“…LBP is an important cause of secondary disability amongst persons with LLA (Morgenroth et al, 2010), with national annual prevalence rates in four countries (United Kingdom, United States, Sweden, and Vietnam) between 50-90% (Ehde et al, 2001;Ephraim et al, 2005;Foote et al, 2015;Hammarlund et al, 2011;Kulkarni et al, 2005;Smith et al, 1999). Following amputation, a one-month prevalence rate of 20-30% (Manchikanti et al, 2014;Sadowski et al, 2022) and a two-year prevalence of 60% (Kulkarni et al, 2005) have been reported. Approximately 25-50% of individuals with LBP report the condition as 'bothersome' and experience di culties performing activities of daily living (ADL), including ambulating and standing up from a chair (Ehde et al, 2001).…”

Successful Powerlifting in a Unilateral, Transtibial Amputee: A Descriptive Case Series

“…Unilateral lower-limb amputees must overcome considerable hardships and intensive rehabilitation in attempt to return to their preamputation levels of physical function. The reduced functional capacity commonly observed in amputees predisposes them to decreased independence, reduced physical activity levels, and increased risk of developing secondary musculoskeletal conditions and comorbidities, such as low back pain (34), joint arthritis (26), and diabetes (39).…”

Exercise Therapy in Nonspecific Low Back Pain among Individuals with Lower-Limb Amputation: A Systematic Review

“…Secondary musculoskeletal disability, such as low back pain (LBP), is among the most important sources of additive disability. In the amputee population, between 52–71% of amputees experience LBP [ 4 , 5 ]. The amount is much higher than in the non-amputee population (12–34%) [ 6 ].…”