Shawn Farrokhi1, Brittney Mazzone2, Susan Eskridge3, Kaeley Shannon4, Owen T Hill5. 1. DoD-VA Extremity Trauma & Amputation Center of Excellence, Fort Sam Houston, TX; The Department of Physical and Occupational Therapy, Naval Medical Center San Diego, San Diego, CA. Electronic address: shawnfarrokhi@gmail.com. 2. DoD-VA Extremity Trauma & Amputation Center of Excellence, Fort Sam Houston, TX; The Department of Physical and Occupational Therapy, Naval Medical Center San Diego, San Diego, CA. 3. Leidos, San Diego, CA. 4. Axiom Resource Management, Inc, San Diego, CA. 5. DoD-VA Extremity Trauma & Amputation Center of Excellence, Fort Sam Houston, TX; Center for the Intrepid, Department of Rehabilitation Medicine, Brooke Army Medical Center, TX.
Abstract
OBJECTIVE: To describe the incidence of overuse musculoskeletal injuries in service members with combat-related lower limb amputation. DESIGN: Retrospective cohort study. SETTING: Military treatment facilities. PARTICIPANTS: Service members with deployment-related lower limb injury (N=791): 496 with a major lower limb amputation and 295 with a mild lower limb injury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The outcomes of interest were clinical diagnosis codes (International Classification of Diseases-9th Revision) associated with musculoskeletal overuse injuries of the lumbar spine, upper limb, and lower limb regions 1 year before and 1 year after injury. RESULTS: The overall incidence of developing at least 1 musculoskeletal overuse injury within the first year after lower limb amputation was between 59% and 68%. Service members with unilateral lower limb amputation were almost twice as likely to develop an overuse lower or upper limb injury than those with mild combat-related injury. Additionally, service members with bilateral lower limb amputation were more than twice as likely to develop a lumbar spine injury and 4 times more likely to develop an upper limb overuse injury within the first year after amputation than those with mild combat-related injury. CONCLUSIONS: Incidence of secondary overuse musculoskeletal injury is elevated in service members with lower limb amputation and warrants focused research efforts toward developing preventive interventions. Published by Elsevier Inc.
OBJECTIVE: To describe the incidence of overuse musculoskeletal injuries in service members with combat-related lower limb amputation. DESIGN: Retrospective cohort study. SETTING: Military treatment facilities. PARTICIPANTS: Service members with deployment-related lower limb injury (N=791): 496 with a major lower limb amputation and 295 with a mild lower limb injury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The outcomes of interest were clinical diagnosis codes (International Classification of Diseases-9th Revision) associated with musculoskeletal overuse injuries of the lumbar spine, upper limb, and lower limb regions 1 year before and 1 year after injury. RESULTS: The overall incidence of developing at least 1 musculoskeletal overuse injury within the first year after lower limb amputation was between 59% and 68%. Service members with unilateral lower limb amputation were almost twice as likely to develop an overuse lower or upper limb injury than those with mild combat-related injury. Additionally, service members with bilateral lower limb amputation were more than twice as likely to develop a lumbar spine injury and 4 times more likely to develop an upper limb overuse injury within the first year after amputation than those with mild combat-related injury. CONCLUSIONS: Incidence of secondary overuse musculoskeletal injury is elevated in service members with lower limb amputation and warrants focused research efforts toward developing preventive interventions. Published by Elsevier Inc.
Authors: Andrea Brandt; William Riddick; Jonathan Stallrich; Michael Lewek; He Helen Huang Journal: J Neuroeng Rehabil Date: 2019-09-11 Impact factor: 4.262