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Abstract
<p class="first" id="d996333e75">Purpose: Approximately 185 000 individuals undergo
limb amputations every year. Of
this population, 40% experience lower extremity amputations. A common musculoskeletal
condition that develops after amputation is chronic low back pain (LBP). LBP may be
a consequence of one or combined mechanical factors including muscle atrophy, strength
loss, level of amputation, kinematic traits of movement, mechanical loading and forces,
prosthetic design/use and leg length discrepancy. Secondary consequences of LBP may
collectively include the dependence of pain medications, impaired physical function,
and diminished quality of life (QOL).Methods: A systematic literature search using
PubMed was conducted to identify articles of low back pain in lower limb amputees.Results:
Long-term interventions are needed to reduce the incidence, prevalence, and secondary
impacts of LBP in amputees. Resistance exercise has strong potential to help correct
mechanical deficits in lower limb amputees. Resistance exercise adaptations that can
be beneficial for this population include improved neuromuscular control, increases
in lumbar and core muscle strength cross-sectional area, and improved gait motion
parameters.Conclusions: This narrative review provides an overview of the key mechanical
and physiological factors which may contribute to chronic LBP in amputees, and discusses
the use of resistance exercise training to combat these mechanical factors to improve
pain symptoms.IMPLICATIONS FOR REHABILITATIONLow back pain is more prevalent in the
amputee population compared to the general population.Low back pain may be due several
mechanical factors that develop after a unilateral amputation.Lower extremity amputees
with chronic low back pain experience compounded physical activity avoidance and functional
limitations.Chronic low back pain in amputees erodes quality of life more than people
with back pain or amputation alone.Therapeutic interventions, such as core strengthening
and stabilization exercises, have strong potential to provide low back pain relief
for amputees.
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