Archives of Physical Medicine and Rehabilitation
Original articleMusculoskeletal Pain and Overuse Syndromes in Adult Acquired Major Upper-Limb Amputees
Section snippets
Design and Participants
We performed a cross-sectional study consisting of a questionnaire survey of ULAs and a control group, and subsequent clinical examinations of a sample of ULAs. Eligible amputees from the known population of adult acquired major ULAs in Norway were invited to participate in the survey. This amputee population was identified through a combined search of the databases of the 2 Norwegian upper-limb prosthesis suppliers and of the medical records of 3 major Norwegian hospitals, going back to 1994
Participants and Response Rates
Of 390 amputees found eligible for the survey, 224 returned questionnaires (57.4%). Of the 224 questionnaire responders, 84 were invited to undergo a clinical examination (37.5%), and 70 were examined (31.3% [83.3% of those invited]). Of 962 eligible controls, 318 returned questionnaires (33.1%).
Population Characteristics
Table 1 shows demographic and amputation-specific features for the QR group, the CE group, and the CR group (demographic features only).
There were no significant differences between the QR group (n=224)
Musculoskeletal Pain
Our findings indicating that ULAs have an increased risk of musculoskeletal pain in the neck/upper back, shoulders, and in the remaining arm are important contributions to the existing literature. Analyzing movements in work-related activities, Black et al19 found that ULAs are at greater risk of cumulative trauma disorders. However, the sample size of that study (3 prosthesis-wearing ULAs vs 20 nonamputated persons) was too small for generalization. The occurrence and distribution of
Conclusions
Our findings indicate that upper-limb loss increases the risk of self-reported musculoskeletal pain in the neck/upper back, shoulders, and in the remaining arm and that prosthesis wear does not prevent such pain. Prevention and treatment of musculoskeletal pain may be important in ULA rehabilitation. We recommend further, longitudinal studies to investigate the development of such pain and the effect of prosthesis wear and possible preventive measures. Overuse syndromes may be frequent in ULAs.
Acknowledgments
We thank Beate Garfelt, MD, for her clinical advice in the production and review of this article.
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Supported by the Innlandet Hospital Trust (grant no. E 06004) and by the Norwegian Extra Foundation for Health and Rehabilitation (grant no. 0225).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.