The association between pain and health status during prosthetic adaptation after lower limb loss-A retrospective chart review.

BACKGROUND

Postamputation pain (PAP) is common and can disrupt the rehabilitation process.

OBECTIVE: The current study's purpose was to examine the associations among early PAP, general and perceived health, during adaptation to prosthetic use through analysis of existing clinical records.

STUDY

DESIGN

Retrospective chart review.

METHODS

In this retrospective chart review, 536 eligible records of patients who were referred for prosthetic rehabilitation at the Portsmouth Enablement Centre were examined. Data were extracted and analyzed from the medical records of 44 patients, encompassing a primary assessment (baseline) after amputation and a 9-month follow-up. Analyses were performed to examine the predictive properties of baseline levels of EQ5D health scores, perceived health, and visual analog scale (VAS) pain ratings, and age, diabetes status, level of amputation, and sex on EQ5D health scores and perceived health at follow-up.

RESULTS

Higher VAS pain intensity ratings at baseline were significantly associated with worse EQ5D health scores and perceived health 9 months later. After accounting for baseline EQ5D health scores and perceived health, VAS pain remained a significant predictor of 9-month EQ5D health scores.

CONCLUSIONS

Early PAP is a risk factor for poorer health, suggesting a possible target for future research investigating multimodal interventions aimed at reducing pain. These interventions and the associated reductions in pain could potentially help facilitate engagement in rehabilitation exercises and prosthesis use to improve functional, psychological, and pain-related outcomes, thereby improving health. Nevertheless, complete data were available for only 44 of 536 eligible records, highlighting a substantial risk of selection bias.