Pain and combat injuries in soldiers returning from Operations Enduring Freedom and Iraqi Freedom: Implications for research and practice

Clark, Michael E.; Buckenmaier, Chester C.; Gironda, R.; Walker, Robert

doi:10.1682/jrrd.2006.05.0057

Cited by 178 publications

(132 citation statements)

References 55 publications

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“…These mean scores are substantially better than those reported by multiple authors for early amputation [5,8,24]. Akula, et al reported the mean physical scores for early amputation were 16.2, and 15.6 for the psychological SIP [1].…”

Section: Discussionmentioning

confidence: 68%

“…One possible explanantion for these findings could involve chronic pain, a common sequelae of limb salvage and a major indication for conversion to amputation [6]. Both Clark, et al and Holbrook, et al reported that experiences involving war injuries in soldiers with poorly controlled pain resulted in chronic pain and posttraumatic stress disorder [8,19]. By removing the painful extremity patients may have reduced levels of chronic pain, resulting in both better functional and psychosocial scores following amputation.…”

Section: Discussionmentioning

confidence: 99%

“…The SIP is a multidimensional measure of self-reported health status that can be self or interviewer administrated. It consists of 136 statements about limitations in twelve categories of function: (1) walking, (2) mobility, (3) body care and movement, (4) social interaction, (5) alertness, (6) emotional behaviour, (7) communication, (8) sleep and rest, (9) eating, (10) work, (11) home management, and (12) recreation and pastimes. Respondents are asked to endorse only the statements that describe their health most accurately on that given day.…”

Section: Outcome Measuresmentioning

confidence: 99%

See 2 more Smart Citations

Functional and psychological outcomes of delayed lower limb amputation following failed lower limb reconstruction

Merwe

Birkholtz

Tetsworth

et al. 2016

Injury

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Purpose:The purpose of this study was to evaluate the functional and psychological outcomes of patients who underwent delayed lower limb amputation following failed limb salvage surgery. Methods:This retrospective, descriptive study evaluated functional outcomes using the Sickness Impact Profile (SIP) and Short Form-36 (SF-36) in 12 patients. Inclusion criteria included patients who underwent limb reconstruction and delayed amputation between between July 2006 and December 2014, with an age range between 18-80 years of age, the ability to ambulate independently, a time interval between the last salvage procedure and amputation greater than six months, and a minimum follow-up of 24 months. Patients were contacted via telephone by the principal investigator and both the Sickness Impact Profile (SIP) and Short Form-36 (SF-36) were completed. Descriptive analysis (means and standard deviation) was used to determine outcomes for both SIP and SF-36 health profiles. Results:Ten patients who had amputations following failed reconstruction (2006-2014) with a mean age of 53+10 years were interviewed. Six patients had a SIP < 5, three patients scored between five and 10 points and one scored >10 points. The main deficit on the SF-36 was in the physical component. The SF-36 scores demonstrated a mean score of 40.8+11.5 for the physical component, and 57.4+7.9 for the mental component. Three patients returned to work after amputation and continued performing their pre-injury duties as farmers.Three other patients returned to work, but were allocated to administrative duties. Two patients were pensioners at the time of their injuries, and the only female patient was a housewife. One patient went into early retirement. Conclusion:The results of this study strongly suggest that delayed amputation following failed limb salvage surgery can still result in good and satisfactory outcomes in the majority of patients and achieves results similar to early amputation and limb reconstruction techniques.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Outcome Measuresmentioning

confidence: 99%

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Functional and psychological outcomes of delayed lower limb amputation following failed lower limb reconstruction

Merwe

Birkholtz

Tetsworth

et al. 2016

Injury

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“…These multiple tours have often included high-intensity conflicts that result in higher rates of injury and trauma exposure. Pain is a significant clinical condition and PTSD is one of the most common psychiatric diagnoses among this population [7][8][9][10][11][12]. Although it is known that these are highly prevalent conditions among individuals returning from recent wars, an understanding of the complexity of the chronic pain and PTSD relationship is limited.…”

Section: Introductionmentioning

confidence: 99%

Pain experience of Iraq and Afghanistan Veterans with comorbid chronic pain and posttraumatic stress

Outcalt

Ang

et al. 2014

J Rehabil Res Dev

Self Cite

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Abstract-Chronic pain and posttraumatic stress disorder (PTSD) co-occur at high rates, and Veterans from recent wars in Iraq and Afghanistan may be particularly vulnerable to both conditions. The objective of this study was to identify key aspects of chronic pain, cognitions, and psychological distress associated with comorbid PTSD among this sample of Veterans. Baseline data were analyzed from a randomized controlled trial testing a stepped-care intervention for chronic musculoskeletal pain. Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans with chronic pain only (n = 173) were compared with those with chronic pain and clinically significant posttraumatic stress symptoms (n = 68). Group differences on pain characteristics, pain cognitions, and psychological distress were evaluated. Results demonstrated that OIF/OEF Veterans with comorbid chronic musculoskeletal pain and PTSD experienced higher pain severity, greater painrelated disability and increased pain interference, more maladaptive pain cognitions (e.g., catastrophizing, self-efficacy, pain centrality), and higher affective distress than those with chronic pain alone. Veterans of recent military conflicts in Iraq and Afghanistan may be particularly vulnerable to the compounded adverse effects of chronic pain and PTSD. These results highlight a more intense and disabling pain and psychological experience for those with chronic pain and PTSD than for those without PTSD. Clinical

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“…Since spinal pain complaints are common in OIF/ OEF veterans [7][8], some of these patients are likely receiving care at VHA chiropractic clinics. However, no data have been published on chiropractic services for OIF/OEF veterans.…”

mentioning

confidence: 99%

Management of Operation Iraqi Freedom and Operation Enduring Freedom veterans in a Veterans Health Administration chiropractic clinic: A case series

Lisi

2010

JRRD

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Abstract-Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans commonly seek care for musculoskeletal complaints in Veterans Health Administration (VHA) facilities. Chiropractic services for musculoskeletal conditions have recently been introduced to VHA. No reports have been published on chiropractic care for OIF/OEF veterans. This study was designed to describe elements of the processes and outcomes of care for OIF/OEF veterans in a VHA chiropractic clinic. A retrospective review of consecutive cases consulted to one VHA chiropractic clinic was conducted. Thirty-one cases were identified. Consultations originated in primary care and specialty clinics that commonly manage musculoskeletal conditions. Military traumatic injury and posttraumatic stress disorder were common. Adverse effects of treatment were mild and transitory. In 19 cases (61%), a pain decrease above the threshold for minimally important change was reported. This article is the first description of health services delivered to OIF/OEF veterans in a VHA chiropractic clinic. Chiropractic management was safe in these cases, and results support the hypothesis that such management may be effective in certain OIF/OIF veterans. A better understanding of the characteristics of these particular patients and the processes of care received in VHA chiropractic clinics is needed to improve the clinical care of these veterans.

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Pain and combat injuries in soldiers returning from Operations Enduring Freedom and Iraqi Freedom: Implications for research and practice

Cited by 178 publications

References 55 publications

Functional and psychological outcomes of delayed lower limb amputation following failed lower limb reconstruction

Functional and psychological outcomes of delayed lower limb amputation following failed lower limb reconstruction

Pain experience of Iraq and Afghanistan Veterans with comorbid chronic pain and posttraumatic stress

Management of Operation Iraqi Freedom and Operation Enduring Freedom veterans in a Veterans Health Administration chiropractic clinic: A case series

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