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The Influence of Tobacco Use, Alcohol Consumption, and Weight Gain on Development of Secondary Musculoskeletal Injury After Lower Limb Amputation.

Authors
  • Yepson, Haylee1
  • Mazzone, Brittney2
  • Eskridge, Susan3
  • Shannon, Kaeley4
  • Awodele, Elizabeth5
  • Farrokhi, Shawn2
  • Mazzone, Brittney6
  • 1 Department of Professional Education, Naval Medical Center San Diego, San Diego, CA.
  • 2 Department of Defense-Veterans Affairs Extremity Trauma and Amputation Center of Excellence, San Diego, CA; Department of Physical and Occupational Therapy, Naval Medical Center San Diego, San Diego, CA.
  • 3 Leidos, San Diego, CA.
  • 4 Axiom Resource Management, Inc., San Diego, CA.
  • 5 Department of Physical Medicine and Rehabilitation, Naval Medical Center San Diego, San Diego, CA.
  • 6 Department of Defense-Veterans Affairs Extremity Trauma and Amputation Center of Excellence, San Diego, CA; Department of Physical and Occupational Therapy, Naval Medical Center San Diego, San Diego, CA. Electronic address: [email protected]
Type
Published Article
Journal
Archives of physical medicine and rehabilitation
Publication Date
Oct 01, 2020
Volume
101
Issue
10
Pages
1704–1710
Identifiers
DOI: 10.1016/j.apmr.2020.04.022
PMID: 32445845
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To evaluate whether tobacco use, alcohol consumption, and weight gain are associated with the diagnosis of overuse musculoskeletal injuries within the first 12 months after lower limb amputation. Retrospective cohort study. Military treatment facilities. Service members (N=681) with a deployment-related lower limb amputation. Not applicable. Clinical diagnosis codes associated with musculoskeletal overuse injuries of the lower limb, upper limb, and low back regions. In the first three months after amputation, tobacco use and alcohol consumption were reported in 55.7% and 72.0%, respectively, of the retrospective sample. The overall mean weight change was 22.9±23.6 pounds. The prevalence of reporting at least 1 overuse injury within 4 to 12 months after amputation was 57.0% in the sample, with prevalence rates of lower limb, upper limb and low back pain diagnoses at 28.3%, 21.7%, and 21.1%, respectively. Service members reporting tobacco use in the first 3 months after amputation were nearly twice as likely to be diagnosed with a lower limb musculoskeletal injury 4 to 12 months after amputation. Similarly, service members reporting alcohol consumption within the first 3 months after amputation were more than twice as likely to be diagnosed with at least 1 overuse musculoskeletal injury 4 to 12 months after amputation. However, weight change or maximum weight after amputation were not associated with the diagnosis of an overuse musculoskeletal injury. Development of secondary overuse musculoskeletal injury appears to be related to tobacco use and alcohol consumption, but not to weight gain. These findings warrant focused research efforts toward developing preventive interventions. Published by Elsevier Inc.

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