Balance and mobility during daily activities, low back pain, amputated and intact side pain in Iranian lower limb amputees

Background and Aim: Lower limb amputation and prosthesis use affect mobility and other aspects of amputees’ daily activities. Awareness of these effects may aid health-care and rehabilitation systems in improving quality of life and well-being of lower limb amputees. A questionnaire was used to collect data about the conditions resulting from lower limb amputation, mobility, low back pain, balance confidence in different activities, and quality of life.    Methods: A survey composed of three standard questionnaires including part of Prosthesis Evaluation Questionnaire (PEQ), complete Activities-Specific Balance Confidence (ABC) Scale questionnaire, and complete Oswestry Disability Index (ODI) was designed and published online. The study’s statistical population included lower limb amputees with any level of amputation who were aged >18 years. The questionnaire was publicised through the prosthetic clinic in the Comprehensive Rehabilitation center of Iranian Red Crescent in Tehran by colleagues working in the fields of amputee rehabilitation, social channels related to disabilities, and the social media of the “Iranian Handicapped Society”. The questionnaire was available online in Persian. Data collection was performed over 16 months (August 2016‒December 2017). Results: Of the 37 respondents (including 1 female and 1 bilateral amputee), many suffered from phantom limb sensation (21 participants/56.8%), phantom limb pain (18 participants/48.6%), stump pain (19 participants/51.4%), intact-side pain (22 participants/59.5%), falls during the last 12 months (22 participants/59.5%) and worry about falling (28 participants/75.7%), deficient balance confidence as measured by the ABC scale (26 participants/70%), and risk of future fallings (17 participants/46%). These problems negatively affected respondents’ ODI scores, ABC scores, mobility scores and quality of life (QoL) scores. However, despite the high rate of lower back pain (LBP) among respondents (22 participants/59.5%), intensity of pain was mild and moderate for the majority. LBP was associated with lower scores of ABC scale, mobility, QoL and amputees satisfaction with prosthesis. According to the ODI, 24% and 32% of participants respectively had minimal and moderate disability due to LBP. Conclusion: Problems related to balance, pain in amputated and intact sides, and LBP were common among respondents. These issues likely impact their mobility and QoL. Accordingly, it is necessary for health care/ rehabilitation systems to include screening plans to monitor these problems and manage them appropriately.