Jóźwik Aleksandra, Wnuk-Scardaccione Agnieszka, Bilski Jan
Graduate of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 8 Skawińska Street, 31-066 Krakow, Poland.
Department of Biomechanics and Kinesiology, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 8 Skawińska Street, 31-066 Krakow, Poland.
Medicina (Kaunas). 2024 Dec 12;60(12):2047. doi: 10.3390/medicina60122047.
: Amputation poses a significant clinical and therapeutic challenge, with over 90.0% of amputations involving the lower limbs, of which 75.0% are associated with diabetes and peripheral artery disease. Individuals with lower limb amputations often experience secondary disabilities. This study aimed to compare the frequency and intensity of lower back pain and phantom pain in individuals with unilateral lower limb amputations who were amputee football players with those who did not participate in adaptive sports. : This study included 30 men who had undergone unilateral lower limb amputation and were divided into two groups: 15 amputee football players and 15 men who did not participate in adapted sports. Testing included proprietary surveys, questionnaires, the Oswestry Disability Index (ODI), and the visual analog scale (VAS) for pain intensity. The Amputee Mobility Predictor (AMPnoPRO) was used to assess motor function. Statistical analysis was performed using Statistica software (Version 13, StatSoft, Inc., Tulsa, OK, USA) by applying Student's -test, the Mann-Whitney U test, correlation coefficients, and analysis of covariance (ANCOVA). Phantom pain was reported in 53.3% of individuals in the study group and in 66.7% of individuals in the control group, with average median pain intensities of 5.5 (IQR: 2) and 5.5 (IQR: 3), respectively. Lower back pain was significantly higher in the control group (86.7%) than for the football players (33.3%), with median pain intensities of 4 (IQR: 2) and 3 (IQR: 2), respectively. The median disability score was 3 (IQR: 3) in the player group and 10 (IQR: 7) in the control group. The median score in the amputee football player group was 35 (IQR: 2), while that in the control group was only 18 (IQR: 19). : Amputee football training did not have a significant impact on the frequency or intensity of phantom pain but was associated with lower occurrence and intensity of pain in the lower back. The players exhibited significantly better motor function and lower levels of disability. Preoperative limb pain was a significant risk factor for phantom pain in the study group. Adaptive sports can not only support the development of motor and social skills but also contribute to reducing the severity of lower back pain, which leads to a decrease in the level of disability.
截肢带来了重大的临床和治疗挑战,超过90.0%的截肢发生在下肢,其中75.0%与糖尿病和外周动脉疾病有关。下肢截肢患者常伴有继发性残疾。本研究旨在比较单侧下肢截肢的截肢足球运动员与未参加适应性运动的患者中腰痛和幻肢痛的频率及强度。本研究纳入了30例接受单侧下肢截肢的男性,分为两组:15名截肢足球运动员和15名未参加适应性运动的男性。测试包括专用调查问卷、问卷、Oswestry功能障碍指数(ODI)以及疼痛强度视觉模拟量表(VAS)。使用截肢者运动预测器(AMPnoPRO)评估运动功能。使用Statistica软件(版本13,StatSoft公司,美国俄克拉荷马州塔尔萨)进行统计分析,采用学生t检验、曼-惠特尼U检验、相关系数和协方差分析(ANCOVA)。研究组53.3%的个体报告有幻肢痛,对照组66.7%的个体报告有幻肢痛,平均疼痛强度中位数分别为5.5(四分位间距:2)和5.5(四分位间距:3)。对照组的腰痛发生率(86.7%)显著高于足球运动员组(33.3%),疼痛强度中位数分别为4(四分位间距:2)和3(四分位间距:2)。运动员组的功能障碍评分中位数为3(四分位间距:3),对照组为10(四分位间距:7)。截肢足球运动员组的评分中位数为35(四分位间距:2),而对照组仅为18(四分位间距:19)。截肢足球训练对幻肢痛的频率或强度没有显著影响,但与较低的腰痛发生率和强度相关。运动员表现出明显更好的运动功能和更低的残疾水平。术前肢体疼痛是研究组幻肢痛的一个重要危险因素。适应性运动不仅有助于运动和社交技能的发展,还能减轻腰痛的严重程度,从而降低残疾水平。