From the Research Department, Providence VA Medical Center, Providence, Rhode Island (LR, MB); Health Services, Policy and Practice, Brown University, Providence, Rhode Island (LR, MAC); and University of Massachusetts Medical School, Worcester, Massachusetts (MAC).
Am J Phys Med Rehabil. 2021 Nov 1;100(11):1042-1053. doi: 10.1097/PHM.0000000000001694.
The aims of the study were (1) to describe frequency of back pain only, neck pain only, and co-occurring pain in veterans with upper limb amputation, (2) to examine changes in pain over 1 yr, and (3) to quantify the association of pain and health-related quality of life and disability.
This is an observational cohort study with a survey of a sample of 792 veterans with upper limb amputation, with 1-yr reassessment of 585 (85.3%) of 777 eligible participants. Pain prevalence and intensity were examined. Logistic and linear regressions identified variables associated with pain and examined associations between intensity and veterans RAND-12 mental component score and physical component score and QuickDASH.
At baseline, 52.3% had co-occurring pain, 20.0% had back pain, and 8.3% had neck pain. Persistent back and neck pain is present in 60.8% and 48.1% respondents, respectively. Pain intensity was unchanged for 59.1% with back pain and 61.3% with neck pain. Mental component score and QuickDASH were significantly worse with severe and moderate back and neck pain, compared with no pain. Severe/moderate back pain intensity was associated with lower physical component score.
Back and neck pain is highly prevalent and persistent in veterans with upper limb amputation. Pain intensity is negatively associated with health-related quality of life and disability. Pain prevention and intervention are needed in this population.
本研究的目的为：(1)描述上肢截肢患者中仅出现背痛、仅出现颈痛和同时出现疼痛的频率；(2)检查疼痛在 1 年内的变化；(3)定量评估疼痛与健康相关生活质量和残疾的相关性。
这是一项观察性队列研究，对 792 名上肢截肢退伍军人进行样本调查，对 777 名符合条件的参与者中的 585 名（85.3%）进行了为期 1 年的重新评估。检查了疼痛的患病率和强度。逻辑和线性回归确定了与疼痛相关的变量，并检查了疼痛强度与退伍军人 RAND-12 心理成分评分和身体成分评分以及 QuickDASH 之间的相关性。
基线时，52.3%的患者同时存在疼痛，20.0%的患者存在背痛，8.3%的患者存在颈痛。持续性背痛和颈痛分别在 60.8%和 48.1%的受访者中存在。59.1%的背痛患者和 61.3%的颈痛患者的疼痛强度保持不变。与无疼痛相比，严重和中度背痛和颈痛患者的心理成分评分和 QuickDASH 明显更差。严重/中度背痛强度与较低的身体成分评分相关。
上肢截肢退伍军人中背痛和颈痛的患病率和持续性都很高。疼痛强度与健康相关生活质量和残疾呈负相关。在该人群中需要进行疼痛预防和干预。
