Exercise intervention for unilateral amputees with low back pain: study protocol for a randomised, controlled trial

Area of Science:

• Musculoskeletal Rehabilitation
• Biomechanics
• Exercise Physiology

Background:

• Lower limb amputation leads to musculoskeletal changes, including muscle atrophy and gait asymmetry.
• Chronic low back pain (LBP) is a common secondary condition in amputees, even with prosthetic use.
• Home-based resistance exercise offers a practical approach to address LBP in this population.

Purpose of the Study:

• To determine if a 12-week home-based resistance exercise (HBRX) program reduces pain severity in unilateral transtibial amputees with chronic LBP.
• To assess the impact of HBRX on secondary outcomes, including quality of life, gait, muscle strength, and daily activity.
• To investigate the relationship between exercise-induced physiological changes and pain reduction.

Main Methods:

• A single-assessor-blinded, randomized controlled trial with 40 participants (18-60 years) with unilateral transtibial amputation.
• Participants were randomized to either a 12-week home-based resistance exercise (HBRX) group or a wait-list control (CON) group.
• HBRX involved elastic resistance bands and bodyweight exercises, with weekly remote monitoring.

Main Results:

• The study is designed to determine the effectiveness of the HBRX program.
• It will analyze changes in pain severity (NRS_pain) as the primary outcome.
• Secondary outcomes include quality of life, gait parameters, muscle morphology, and strength.

Conclusions:

• The findings will establish whether HBRX is effective in reducing LBP for unilateral transtibial amputees.
• The study will elucidate the physiological and mechanical mechanisms underlying pain reduction.
• This research can inform the development of targeted rehabilitation strategies for amputees experiencing chronic LBP.