Frequency of Low Back Pain and its Effect on Function and HealthRelated Quality of Life across Three Levels of Lower Limb Amputation: A Cross-Sectional Study

Abstract

Background: Amputation is a profoundly life-altering event that can have both physical and psychological impacts on individuals. Objective: This study aimed to investigate the frequency of low back pain and its effect on function and health-related quality of life in individuals with various levels of lower limb amputation. Methods: It was a cross-sectional study at the Pakistan Institute of Prosthetic and Orthotics Peshawar (PIPOS) from May to September 2020, 264 participants were purposively selected. Inclusion criteria: males and females aged 18-65 with unilateral transfemoral, knee disarticulation, or transtibial amputations. Exclusion criteria: hearing/speech impairments, hip pathology, or bilateral lower limb amputation. Data collected via selfadministered questionnaires, including the Roland Morris Disability Questionnaire (RMDQ) and the Short Form 36 Health Survey (SF-36). Data analyzed using SPSS v.25. Results: Of the 264 participants, 219 were males (83%), and 45 were females (17%). There was significant connection between before and after amputation back pain (P < 0.05). However, no notable link was observed between low back pain and the three amputation levels (P > 0.05). Moreover, there was no statistical disparity in disability based on the level of amputation (P > 0.05). Significantly, low back pain differed across all quality of life domains (P < 0.05), except for mental and physical health. In contrast, no statistical variation was noted in the quality of life among the three amputation levels (P > 0.05). Conclusion: This study underscores the prevalence of low back pain in lower limb amputees. However, we did not find a clear association between low back pain and specific amputation levels (unilateral transfemoral, knee disarticulation, or transtibial amputation). Additionally, low back pain appears to impact disability and select aspects of quality of life, such as physical function, social function, and general health in individuals with lower limb amputation.