Lower Back Pain in the ADVANCE Cohort & Foot/Ankle Pain in ADVANCE Unilateral Transfemoral Amputees

Hypothesis

Injured participants will have more lower back pain than uninjured participants and, of those, those who had a back injury, and lower limb amputees, and unilateral lower limb amputees will have the highest levels of lower back pain. Lower back pain in amputees will be different depending on unilateral/bilateral status and level of amputation. At FU1, LBP will progress faster in lower limb amputees. Foot/ankle project: Unilateral transfemoral amputees will have more foot and ankle pain/dysfunction on their intact side limb due to the need to raise the heel during the swing phase of the amputation-side limb. These two projects are linked because pelvic ‘hitching’ is hypothesised to increase LBP and pelvic hitching plus/minus ankle ‘vaulting’ are the two mechanisms used by unilateral above-knee amputees to reach foot clearance.

Summary

This project consists of:

LBP project: Report the risk of lower back pain in the ADVANCE cohort and the effect of biopsychosocial factors with a particular focus on lower limb amputees. Interested in change over time between baseline and FU1.

Foot/ankle project: Report foot and ankle pain in the ADVANCE cohort with a particular focus on unilateral transfemoral amputees.

The Hypotheses of the above-mentioned projects are:

LBP project: Injured participants will have more lower back pain than uninjured participants and, of those, those who had a back injury, and lower limb amputees, and unilateral lower limb amputees will have the highest levels of lower back pain. Lower back pain in amputees will be different depending on unilateral/bilateral status and level of amputation. At FU1, LBP will progress faster in lower limb amputees.

Foot/ankle project: Unilateral transfemoral amputees will have more foot and ankle pain/dysfunction on their intact side limb due to the need to raise the heel during the swing phase of the amputation-side limb. These two projects are linked because pelvic ‘hitching’ is hypothesised to increase LBP and pelvic hitching plus/minus ankle ‘vaulting’ are the two mechanisms used by unilateral above-knee amputees to reach foot clearance.

Keywords

Back Pain, Amputation, Foot Pain, Ankle Pain, Musculoskeletal


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