Jill M Cancio1, Susan Eskridge2, Kaeley Shannon3, Annemarie Orr4, Brittney Mazzone5, Shawn Farrokhi5. 1. US Army Institute of Surgical Research, JBSA Fort Sam Houston, TX 78234, USA; Center for the Intrepid, Department of Rehabilitation Medicine, Brooke Army Medical Center, JBSA Fort Sam Houston, TX 78234, USA; Extremity Trauma and Amputation Center of Excellence, JBSA Fort Sam Houston, TX 78234, USA. Electronic address: jill.m.cancio.civ@mail.mil. 2. Leidos, San Diego, CA, USA. 3. Axiom Resource Management, Inc., San Diego, CA, USA. 4. Naval Medical Center San Diego, , San Diego, CA 92134, USA. 5. Extremity Trauma and Amputation Center of Excellence, JBSA Fort Sam Houston, TX 78234, USA; Axiom Resource Management, Inc., San Diego, CA, USA.
Abstract
STUDY DESIGN: Retrospective cohort study INTRODUCTION: Service members who have sustained traumatic amputations are typically young and otherwise healthy. Beyond standard care, these individuals desire long, highly active, and relatively pain-free lifestyle, whether that is returning to active duty or transitioning to civilian life. Development of overuse musculoskeletal conditions could have a significant influence on quality of life for Service members with traumatic upper limb amputation. PURPOSE OF THE STUDY: Compare one-year incidence of overuse musculoskeletal injuries in Service members with different levels of combat-related upper limb amputation to Service members with minor combat-related upper limb injuries. METHODS: Service members with deployment-related upper limb injury (N = 519), 148 major upper limb amputation (55 with amputation at or above elbow, 93 with amputation below elbow) and 371 minor upper limb injury were included in the study. Outcomes of interest clinical diagnosis codes associated with overuse conditions of the upper limb, neck and upper back, lower limb, low back pain, and all regions combined, one year before and one year after injury. RESULTS: Overall, the one-year incidence of developing at least one musculoskeletal overuse condition after upper limb amputation was between 60% and 65%. Service members with upper limb amputations were 2.7 to 4.7 times more likely to develop an overuse upper limb condition, 3.6 to 3.8 times more likely to develop a neck and upper back condition, 2.8 to 4.4 times more likely to develop a lower limb condition, and 3.3 to 3.9 times more likely to develop low back pain as compared those who sustained minor combat-related injuries. No significant differences in the odds of developing a musculoskeletal condition was found between the above elbow and below elbow amputation groups. CONCLUSIONS: Incidence of secondary overuse conditions is elevated in Service members with upper limb amputation and warrants focused research efforts toward preventative and rehabilitative interventions.
STUDY DESIGN: Retrospective cohort study INTRODUCTION: Service members who have sustained traumatic amputations are typically young and otherwise healthy. Beyond standard care, these individuals desire long, highly active, and relatively pain-free lifestyle, whether that is returning to active duty or transitioning to civilian life. Development of overuse musculoskeletal conditions could have a significant influence on quality of life for Service members with traumatic upper limb amputation. PURPOSE OF THE STUDY: Compare one-year incidence of overuse musculoskeletal injuries in Service members with different levels of combat-related upper limb amputation to Service members with minor combat-related upper limb injuries. METHODS: Service members with deployment-related upper limb injury (N = 519), 148 major upper limb amputation (55 with amputation at or above elbow, 93 with amputation below elbow) and 371 minor upper limb injury were included in the study. Outcomes of interest clinical diagnosis codes associated with overuse conditions of the upper limb, neck and upper back, lower limb, low back pain, and all regions combined, one year before and one year after injury. RESULTS: Overall, the one-year incidence of developing at least one musculoskeletal overuse condition after upper limb amputation was between 60% and 65%. Service members with upper limb amputations were 2.7 to 4.7 times more likely to develop an overuse upper limb condition, 3.6 to 3.8 times more likely to develop a neck and upper back condition, 2.8 to 4.4 times more likely to develop a lower limb condition, and 3.3 to 3.9 times more likely to develop low back pain as compared those who sustained minor combat-related injuries. No significant differences in the odds of developing a musculoskeletal condition was found between the above elbow and below elbow amputation groups. CONCLUSIONS: Incidence of secondary overuse conditions is elevated in Service members with upper limb amputation and warrants focused research efforts toward preventative and rehabilitative interventions.
Authors: Dawn Finnie; Joan M Griffin; Cassie C Kennedy; Karen Schaepe; Kasey Boehmer; Ian Hargraves; Hatem Amer; Sheila Jowsey-Gregoire Journal: Front Psychol Date: 2022-09-27