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Protective and Risk Factors for Phantom Limb Pain and Residual Limb Pain Severity.

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Title: Protective and Risk Factors for Phantom Limb Pain and Residual Limb Pain Severity.
Authors: Münger, Marionna, Pinto, Camila B., Pacheco‐Barrios, Kevin, Duarte, Dante, Enes Gunduz, Muhamed, Simis, Marcel, Battistella, Linamara R., Fregni, Felipe
Source: Pain Practice. Jul2020, Vol. 20 Issue 6, p578-587. 10p. 5 Charts.
Subjects: Age distribution, Amputation, Amputees, Chronic pain, Leg, Multivariate analysis, Pain, Statistics, Wounds & injuries, Pain measurement, Cross-sectional method, Descriptive statistics
Abstract: Introduction: The exact mechanisms underlying the development and maintenance of phantom limb pain (PLP) are still unclear. This study aimed to identify the factors affecting pain intensity in patients with chronic, lower limb, traumatic PLP. Methods: This is a cross‐sectional analysis of patients with PLP. We assessed amputation‐related and pain‐related clinical and demographic variables. We used univariate and multivariate models to evaluate the associated factors modulating PLP and residual limb pain (RLP) intensity. Results: We included 71 unilateral traumatic lower limb amputees. Results showed that (1) amputation‐related perceptions were experienced by a large majority of the patients with chronic PLP (sensations: 90.1%, n = 64; residual pain: 81.7%, n = 58); (2) PLP intensity has 2 significant protective factors (phantom limb movement and having effective treatment for PLP previously) and 2 significant risk factors (phantom limb sensation intensity and age); and (3) on the other hand, for RLP, risk factors are different: presence of pain before amputation and level of amputation (in addition to the same protective factors). Conclusion: These results suggest different neurobiological mechanisms to explain PLP and RLP intensity. While PLP risk factors seem to be related to maladaptive plasticity, since phantom sensation and older age are associated with more pain, RLP risk factors seem to have components leading to neuropathic pain, such as the amount of neural lesion and previous history of chronic pain. Interestingly, the phantom movement appears to be protective for both phenomena. [ABSTRACT FROM AUTHOR]
Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Protective and Risk Factors for Phantom Limb Pain and Residual Limb Pain Severity.
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  Data: <searchLink fieldCode="JN" term="%22Pain+Practice%22">Pain Practice</searchLink>. Jul2020, Vol. 20 Issue 6, p578-587. 10p. 5 Charts.
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  Data: <searchLink fieldCode="DE" term="%22Age+distribution%22">Age distribution</searchLink><br /><searchLink fieldCode="DE" term="%22Amputation%22">Amputation</searchLink><br /><searchLink fieldCode="DE" term="%22Amputees%22">Amputees</searchLink><br /><searchLink fieldCode="DE" term="%22Chronic+pain%22">Chronic pain</searchLink><br /><searchLink fieldCode="DE" term="%22Leg%22">Leg</searchLink><br /><searchLink fieldCode="DE" term="%22Multivariate+analysis%22">Multivariate analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Pain%22">Pain</searchLink><br /><searchLink fieldCode="DE" term="%22Statistics%22">Statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Wounds+%26+injuries%22">Wounds & injuries</searchLink><br /><searchLink fieldCode="DE" term="%22Pain+measurement%22">Pain measurement</searchLink><br /><searchLink fieldCode="DE" term="%22Cross-sectional+method%22">Cross-sectional method</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Introduction: The exact mechanisms underlying the development and maintenance of phantom limb pain (PLP) are still unclear. This study aimed to identify the factors affecting pain intensity in patients with chronic, lower limb, traumatic PLP. Methods: This is a cross‐sectional analysis of patients with PLP. We assessed amputation‐related and pain‐related clinical and demographic variables. We used univariate and multivariate models to evaluate the associated factors modulating PLP and residual limb pain (RLP) intensity. Results: We included 71 unilateral traumatic lower limb amputees. Results showed that (1) amputation‐related perceptions were experienced by a large majority of the patients with chronic PLP (sensations: 90.1%, n = 64; residual pain: 81.7%, n = 58); (2) PLP intensity has 2 significant protective factors (phantom limb movement and having effective treatment for PLP previously) and 2 significant risk factors (phantom limb sensation intensity and age); and (3) on the other hand, for RLP, risk factors are different: presence of pain before amputation and level of amputation (in addition to the same protective factors). Conclusion: These results suggest different neurobiological mechanisms to explain PLP and RLP intensity. While PLP risk factors seem to be related to maladaptive plasticity, since phantom sensation and older age are associated with more pain, RLP risk factors seem to have components leading to neuropathic pain, such as the amount of neural lesion and previous history of chronic pain. Interestingly, the phantom movement appears to be protective for both phenomena. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/papr.12881
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        Text: English
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        PageCount: 10
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      – SubjectFull: Age distribution
        Type: general
      – SubjectFull: Amputation
        Type: general
      – SubjectFull: Amputees
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      – SubjectFull: Chronic pain
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      – SubjectFull: Leg
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      – SubjectFull: Multivariate analysis
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      – SubjectFull: Cross-sectional method
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      – SubjectFull: Descriptive statistics
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              Text: Jul2020
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              Y: 2020
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