Department of Physical Medicine and Rehabilitation, Burn research center, Shiraz University of Medical Sciences, Iran.
Disabil Rehabil. 2012;34(10):869-72. doi: 10.3109/09638288.2011.623756. Epub 2011 Oct 29.
To determine the impact of pain in the vertebral column on the activities of daily living (ADL) level of war victims with bilateral lower limb amputation.
All the war-related bilateral lower limb amputees were invited. More than half of them (n = 335) participated and underwent a thorough assessment after giving informed consent.
The majority of the participants were male (97.6%). Their mean age was 42 years and 97.6% of them were married. The most common causes of injury leading to amputation were shells of artillery and mortar (56.7%). The most common level of amputation was bilateral transtibial (37.6%) and 64% were wearing the prosthesis of both sides. The most ADL dependency were transfer activities (27.8%) and bathing (23.3%) and the most independent functioning was eating (97.6%). Upper cervical vertebral pain was associated with dependency in the bowel and bladder management and dressing (p < 0.03 and p < 0.04, respectively). Pain in the lower cervical vertebrae was associated with dependency in toileting and dressing (p < 0.01 and p < 0.01, respectively). There were significant relationships between pain in the thoracic vertebrae and dependency in bathing, transfer activities and toileting (p < 0.02, p < 0.003 and p < 0.03, respectively). Pain in the lumbosacral region had a relationship with the level of amputation, transfer activities and toileting (p < 0.006, p < 0.03 and p < 0.05, respectively).
Vertebral pain in bilateral lower limb amputees, especially lumbosacral pain, was accompanied with higher dependency in ADL. Therefore, a multidisciplinary approach to the management of pain is required to minimize disability and maximize functioning.
确定脊柱疼痛对双侧下肢截肢的战争伤员日常生活活动（ADL）水平的影响。
邀请所有与战争相关的双侧下肢截肢者。在获得知情同意后，超过一半的人（n=335）参与并接受了彻底评估。
大多数参与者为男性（97.6%）。他们的平均年龄为 42 岁，97.6%的人已婚。导致截肢的最常见损伤原因是炮弹和迫击炮弹（56.7%）。最常见的截肢部位是双侧胫骨（37.6%），64%的人两侧都戴着假肢。最依赖 ADL 的活动是转移活动（27.8%）和洗澡（23.3%），最独立的功能是进食（97.6%）。上颈椎疼痛与肠和膀胱管理及穿衣依赖有关（p<0.03 和 p<0.04）。下颈椎疼痛与如厕和穿衣依赖有关（p<0.01 和 p<0.01）。胸椎疼痛与洗澡、转移活动和如厕依赖之间存在显著关系（p<0.02、p<0.003 和 p<0.03）。腰骶部疼痛与截肢水平、转移活动和如厕依赖有关（p<0.006、p<0.03 和 p<0.05）。
双侧下肢截肢者的脊柱疼痛，尤其是腰骶部疼痛，与 ADL 更高的依赖性有关。因此，需要采用多学科方法来管理疼痛，以最大限度地减少残疾和发挥最大功能。
