单侧下肢截肢的成年人：疼痛的空间范围越大，调整越差，活动受限越大，对假肢的满意度越低。
Adults with unilateral lower-limb amputation: greater spatial extent of pain is associated with worse adjustment, greater activity restrictions, and less prosthesis satisfaction.
机构信息
Department of Physical Therapy, University of Delaware, Newark, DE, USA.
VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), VA Eastern Colorado Health Care System, Aurora, CO, USA.
出版信息
Scand J Pain. 2022 Feb 1;22(3):578-586. doi: 10.1515/sjpain-2021-0132. Print 2022 Jul 26.
OBJECTIVES
This study's primary purpose was to determine if the extent of bodily pain, as evaluated with pain body diagrams, is associated with prosthetic-related activity restrictions, adjustment, and satisfaction among adults with a major unilateral lower-limb amputation. A secondary objective was to evaluate between-days, test-retest reliability for pain body diagrams among adults with lower-limb amputation.
METHODS
Adults with a lower-limb amputation that occurred ≥1 year prior participated in an online, cross-sectional research study. Outcome measures included pain body diagrams and the Trinity Amputation and Prosthesis Experience Scales-Revised, which evaluates post-amputation activity restrictions, psychosocial adjustment, and prosthesis satisfaction. Linear regression modeling was used to evaluate associations between the number of painful body regions and prosthetic outcomes, after considering covariates (alpha ≤ 0.010). A subset of participants recompleted pain body diagrams to evaluate between-days, test-retest reliability.
RESULTS
Data from 74 participants (n = 32 female; n = 42 transtibial-level; n = 27 traumatic etiology) were available. Beyond covariates (i.e., age, sex, amputation level), the total number of painful body regions was significantly associated with all Trinity Amputation and Prosthesis Experience Scales-Revised subscales (p < 0.001-0.006), with the exception of Social Adjustment (p = 0.764). The total number of painful body regions explained 14.5, 11.8, 11.6, and 7.4% of the variance in Functional Satisfaction with the Prosthesis, Adjustment to Limitation, General Adjustment, and Activity Restriction, respectively. In a subset (n = 54), test-retest reliability for total number of painful body regions per body diagrams was good [intraclass correlation coefficient (ICC) = 0.84].
CONCLUSIONS
A greater number of painful body regions is associated with greater activity restriction, worse adjustment, and lower prosthesis satisfaction, supporting the need to enhance post-amputation pain management and both amputated- and secondary-site pain prevention.
ETHICAL COMMITTEE NUMBER
IRB #1611862.
目的
本研究的主要目的是确定身体疼痛的程度（通过疼痛体图评估）是否与成年人单侧下肢大截肢后与假肢相关的活动受限、适应和满意度相关。次要目的是评估下肢截肢成年人疼痛体图的日内、重测信度。
方法
参加本在线横断面研究的成年人单侧下肢截肢发生时间超过 1 年。研究结果包括疼痛体图和经修订的三位一体截肢和假肢体验量表，该量表评估截肢后活动受限、心理社会适应和假肢满意度。线性回归模型用于评估考虑协变量（α≤0.010）后疼痛体图的身体疼痛区域数量与假肢结果之间的关联。一组参与者重新完成疼痛体图，以评估日内、重测信度。
结果
74 名参与者（n=32 名女性；n=42 名胫骨水平截肢；n=27 外伤性病因）的数据可用。除了协变量（即年龄、性别、截肢水平）外，身体疼痛区域的总数与三位一体截肢和假肢体验量表修订版的所有子量表均显著相关（p<0.001-0.006），除社会适应（p=0.764）外。身体疼痛区域的总数分别解释了假肢功能满意度、限制适应、总体适应和活动受限的 14.5%、11.8%、11.6%和 7.4%的变异。在亚组（n=54）中，疼痛体图中身体疼痛区域总数的重测信度良好（组内相关系数（ICC）=0.84）。
结论
更多的身体疼痛区域与更大的活动受限、更差的适应和更低的假肢满意度相关，这支持了增强截肢后疼痛管理以及截肢部位和继发性疼痛预防的必要性。
伦理委员会编号
IRB#1611862。
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