Pain and pain-related interference in adults with lower-limb amputation: comparison of knee-disarticulation, transtibial, and transfemoral surgical sites.
Pain and pain-related interference in adults with lower-limb amputation: comparison of knee-disarticulation, transtibial, and transfemoral surgical sites.
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DOI：
10.1682/jrrd.2008.07.0085
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发表时间：
2009
影响因子：
--
通讯作者：
Smith DG
中科院分区：
文献类型：
--
作者：
Behr J;Friedly J;Molton I;Morgenroth D;Jensen MP;Smith DG
疼痛以及与疼痛相关的对身体功能的干预尚未在接受膝关节脱节截肢的个体中进行彻底的研究。这项研究的主要目的是确定膝关节脱节截肢的个体是否比经胫骨或经股骨截肢的个体有更严重的疼痛以及与疼痛相关的身体功能干扰。我们分析了42例成人截肢患者提供的横断面调查数据。这些受试者包括14名报告一侧肢体膝关节脱位截肢的成年人和最匹配的病例(14例报告经股截肢，14例报告经胫骨截肢)，这些病例来自472名更大的横断面样本。参与者根据截肢时间、截肢原因、年龄、性别、糖尿病诊断和截肢前疼痛进行严格匹配。用单因素方差分析对连续结果变量进行分析。分类结果采用皮尔逊卡方检验。考虑到相对较小的样本量和功率考虑，平均差异也可以用估计效应量(Cohen‘s d)来描述。在42名参与者中，83%是男性。年龄在36-85岁之间(中位数为55.1，标准差为11.0)。大多数截肢是创伤性的(74%)，调查时参与者距截肢的平均时间为12.4年。经胫骨截肢患者报告的假体使用量明显多于膝关节脱位截肢患者。截肢程度在幻肢疼痛、残肢疼痛、背部疼痛以及疼痛对身体功能的干扰方面没有显著差异。然而，对效应大小的估计表明，与胫骨或股骨截肢的参与者相比，膝关节脱节截肢的参与者报告的幻肢疼痛、幻肢疼痛对身体功能的干扰、残肢疼痛、残肢疼痛对身体功能的干扰以及背部疼痛对身体功能的干扰较少。这项研究表明，膝关节脱节截肢患者使用假体的次数明显少于经胫骨截肢患者。然而，没有证据表明膝关节脱节截肢患者在疼痛和与疼痛相关的身体功能干扰方面的结果更差；事实上，他们可能有更有利的长期结果。
Pain and pain-related interference with physical function have not been thoroughly studied in individuals who have undergone knee-disarticulation amputations. The principal aim of this study was to determine whether individuals with knee-disarticulation amputations have worse pain and pain-related interference with physical function than do individuals with transtibial or transfemoral amputations. We analyzed cross-sectional survey data provided by 42 adults with lower-limb amputations. These individuals consisted of 14 adults reporting knee-disarticulation amputation in one limb and best-matched cases (14 reporting transfemoral amputation and 14 reporting transtibial amputation) from a larger cross-sectional sample of 472 individuals. Participants were rigorously matched based on time since amputation, reason for amputation, age, sex, diabetes diagnosis, and pain before amputation. Continuous outcome variables were analyzed by one-way analysis of variance. Categorical outcomes were analyzed by Pearson chi-square statistic. Given the relatively small sample size and power concerns, mean differences were also described by estimated effect size (Cohen’s d). Of the 42 participants, 83% were male. They ranged in age from 36 to 85 (median = 55.1, standard deviation = 11.0). Most amputations were of traumatic origin (74%), and participants were on average 12.4 years from their amputations at the time of the survey. Individuals with transtibial amputation reported significantly more prosthesis use than did individuals with knee-disarticulation amputation. Amputation levels did not significantly differ in phantom limb pain, residual limb pain, back pain, and pain-related interference with physical function. Estimates of effect size, however, indicated that participants with knee-disarticulation amputation reported less phantom limb pain, phantom limb pain-related interference with physical function, residual limb pain, residual limb pain-related interference with physical function, and back pain-related interference with physical function than did participants with transtibial or transfemoral amputations. This study demonstrated that patients with knee-disarticulation amputation used prostheses significantly less than did patients with transtibial amputation. However, no evidence was found that patients with knee-disarticulation amputation have worse outcomes in terms of pain and pain-related interference with physical function; in fact, they may have more favorable long-term outcomes.
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影响因子：
2.6
作者：
Kock, HJ;Friederichs, J;Gumppenberg, S
通讯作者：
Gumppenberg, S
影响因子：
4.3
作者：
Ehde, DM;Czerniecki, JM;Robinson, LR
通讯作者：
Robinson, LR
DOI：
10.1016/j.apmr.2004.06.072
发表时间：
2005-03-01
影响因子：
4.3
作者：
Dillingham, TR;Pezzin, LE;Shore, AD
通讯作者：
Shore, AD
影响因子：
4.3
作者：
Ehde, DM;Smith, DG;Robinson, RLR
通讯作者：
Robinson, RLR
DOI：
10.2106/00004623-198870050-00016
发表时间：
1988-06-01
影响因子：
5.3
作者：
PINZUR, MS;SMITH, DG;OSTERMAN, H
通讯作者：
OSTERMAN, H