Department of Physical Medicine and Rehabilitation, Innlandet Hospital Trust, Ottestad, Norway.
Arch Phys Med Rehabil. 2011 Dec;92(12):1967-1973.e1. doi: 10.1016/j.apmr.2011.06.026.
(1) To compare the prevalence of self-reported musculoskeletal pain in upper-limb amputees (ULAs) in Norway with that of a control group drawn from the Norwegian general population; (2) to describe musculoskeletal pain bothersomeness in ULAs; (3) to estimate the association between prosthesis wear and self-reported musculoskeletal pain in ULAs; and (4) to describe the occurrence of musculoskeletal overuse syndromes in a sample of ULAs.
Cross-sectional study: postal questionnaires and clinical examinations.
Norwegian ULA population. Clinical examinations performed at 3 clinics.
Questionnaires: population-based amputee sample (n=224; 57.4% response rate). Random control sample (n=318; 33.1% response rate). Clinical examinations: combined referred sample and convenience sample (n=70; 83.3% of those invited). Survey inclusion criteria: adult, resident in Norway and mastering Norwegian (amputees and controls), acquired major upper-limb amputation (amputees only).
Not applicable.
Self-reported musculoskeletal pain and pain bothersomeness. Self-reported pain in prosthesis wearers and nonwearers. Clinically assessed diagnoses of musculoskeletal overuse syndromes.
Self-reported musculoskeletal pain was more frequent in ULAs than in the control group except for lower back pain. In ULAs, 57.0% reported neck/upper back pain (odds ratio [OR]=2.56; 95% confidence interval [CI], 1.64-3.98), and 58.9% reported shoulder pain (OR=4.00; 95% CI, 2.51-6.36). The percentage difference for arm pain was 24.8% (P<.001). All pain was reported as bothersome. We found no difference in pain prevalence between prosthesis wearers and nonwearers. Musculoskeletal overuse syndromes were found in 6.1% to 24.2% of ULAs, depending on diagnosis and case-definition criteria.
Upper-limb loss increases the risk of self-reported musculoskeletal pain in the neck/upper back, shoulders, and in the remaining arm. Prosthesis wear does not prevent musculoskeletal pain. Further studies should be conducted to investigate the effects of prosthesis wear and possible preventive measures, and to ascertain our preliminary prevalence estimates of overuse syndromes.
（1）比较挪威上肢截肢者（ULAs）与挪威普通人群中对照组报告的肌肉骨骼疼痛的患病率；（2）描述 ULAs 肌肉骨骼疼痛的困扰程度；（3）估计义肢佩戴与 ULAs 自我报告肌肉骨骼疼痛之间的关联；（4）描述 ULAs 样本中肌肉骨骼过度使用综合征的发生情况。
横断面研究：邮寄问卷和临床检查。
挪威 ULA 人群。在 3 家诊所进行临床检查。
问卷调查：基于人群的截肢者样本（n=224；57.4%的回复率）。随机对照样本（n=318；33.1%的回复率）。临床检查：综合转诊样本和方便样本（n=70；邀请人数的 83.3%）。调查纳入标准：成人、居住在挪威并精通挪威语（截肢者和对照组）、上肢获得性主要截肢（仅截肢者）。
不适用。
自我报告的肌肉骨骼疼痛和疼痛困扰程度。报告义肢佩戴者和非佩戴者的疼痛。临床评估的肌肉骨骼过度使用综合征诊断。
与对照组相比，ULAs 报告肌肉骨骼疼痛的频率更高，除了下腰痛。在 ULAs 中，57.0%报告颈部/上背部疼痛（比值比[OR]=2.56；95%置信区间[CI]，1.64-3.98），58.9%报告肩部疼痛（OR=4.00；95% CI，2.51-6.36）。手臂疼痛的百分比差异为 24.8%（P<.001）。所有疼痛均被报告为困扰。我们在义肢佩戴者和非佩戴者之间没有发现疼痛发生率的差异。根据诊断和病例定义标准，在 6.1%至 24.2%的 ULAs 中发现了肌肉骨骼过度使用综合征。
上肢丧失会增加颈部/上背部、肩部和剩余手臂自我报告肌肉骨骼疼痛的风险。义肢佩戴并不能预防肌肉骨骼疼痛。应进一步开展研究，以调查义肢佩戴和可能的预防措施的影响，并确定我们对过度使用综合征的初步患病率估计。
