title: A Clinical Evaluation of Postamputation Phenomena Including Phantom Limb Pain after Lower Limb Amputation in Dysvascular Patients.
abstract: To explore the effects of phantom phenomena on a group of dysvascular lower limb amputees. This was a cross-sectional study of dysvascular lower limb amputees. A modified version of the phantom phenomena questionnaire was used to measure the prevalence of phantom phenomena and the effects of those phenomena on daily life. Eighty-nine amputees were recruited. The majority were inpatients (72%) and male (72%). Most had pain before amputation (83%). Sixty-three percent had phantom limb pain. No associations were found between phantom limb pain and preamputation pain (p = .397). Phantom limb pain was present immediately on waking from amputation in 23%. Phantom limb pain is highly fluctuant. It is more likely that phantom limb pain was present with more time passed since amputation (p = .002). Outpatients with unhealed wounds were less likely to have phantom limb pain (p = .007). The effects of postamputation phenomena include sleep loss and social restrictions. These results challenge the belief that phantom limb pain reduces over time as more outpatients reported phantom limb pain than inpatients. Preamputation pain is not linked to the presence of phantom limb pain. The fluctuant nature of phantom limb pain makes its treatment complex. Some may wish intensity to reduce, whereas others may prefer to reduce the number of episodes or duration of each episode instead. More research is needed to clarify the needs of amputees in relation to the postamputation phenomena.
authors.affiliation: University of Manchester, School of Nursing, Midwifery and Social Work, Manchester, UK. Electronic address: clifford.richardson@manchester.ac.uk.
authors.forename: Cliff
authors.initials: C
authors.lastname: Richardson
authors.affiliation: University Hospitals of South Manchester Foundation Trust, Specialized Ability Centre, Manchester, UK.
authors.forename: Kath
authors.initials: K
authors.lastname: Crawford
authors.affiliation: Central Manchester Foundation Trust, Amputee Outreach Team, Manchester, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Milnes
authors.affiliation: Central Manchester Foundation Trust, Amputee Outreach Team, Manchester, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bouch
authors.affiliation: University Hospitals of South Manchester Foundation Trust, Specialized Ability Centre, Manchester, UK.
authors.forename: Jai
authors.initials: J
authors.lastname: Kulkarni
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D000700:Analgesics / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology*; D010147:Pain Measurement; D016491:Peripheral Vascular Diseases / Q000601:surgery*; D010591:Phantom Limb / Q000188:drug therapy / Q000453:epidemiology*; D015995:Prevalence; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D000700:Analgesics