Andre SugawaraInstitute of Physical Medicine and Rehabilitation, Brazil
Title: Characterisation of phantom limb pain in traumatic lower-limb amputees
There are no diagnosis for phantom limb pain (PLP) and its investigation is based on anamnesis, which is subject to several biases. This is a cross-sectional study involving patients with unilateral traumatic lower limb amputation aged over 18 years. Those with clinical decompensation or evidence of disease, trauma, or surgery in the central or peripheral nervous system were excluded. Sociodemographic and rehabilitative data were collected; PLP was characterised using the visual analogue scale (VAS), descriptors of pain intensity and weekly frequency. A total of 55 eligible patients participated; most were male, young, above-knee amputees in the pre-prosthetic phase of the rehabilitation. The median VAS for PLP was 60 (50-79.3) mm characterised by 13 (6-20) different descriptors in the same patient, which coexist, alternate, and add up to a frequency of 3.94 (2.5-4.38) times per week. The most frequent descriptor was movement (70.91%) of the phantom limb. Tingling, numbness, flashing, itchiness, spasm, tremor, and throbbing are statistically significant PLP descriptors predicted for above-knee amputation, the prosthetic phase, education level, and greater PLP intensity by VAS (p<0.05). Conclusion: PLP is not a single symptom. It is characterised by different sensations and perceptions that need directed and guided anamnesis for appropriate diagnosis.
Andre Sugawara is a physiatrist with master degree in health sciences, PHD in progress. Develops his work at Instituto de Medicina Fisica e Reabilitacao – Rede de Reabilitacao Lucy Montoro at Universidade de Sao Paulo- Brazil. Developed a wheelchair for active people and has publications about disabilities management.