Prevalence of neck pain among unilateral upper limb amputees: A systematic review and meta-analysis

Neck pain is a significant health concern for unilateral upper limb amputees (UULAs), affecting their functional status and quality of life.

To address the neck pain burden that is adding to UULA's pre-existing disability and help Physical therapists to judiciously design and execute effective therapeutic strategies.

We searched databases for articles till October 23, 2023, and included primary studies reporting neck pain prevalence among UULAs. PRISMA and MOOSE guidelines were adhered to extract data and quality assessment. Heterogeneity was assessed using prediction interval and I². We performed a random-effects meta-analysis, sub-group analyses, meta-regression, and publication bias assessment. We visualized them using forest plots, bubble plot, and Doi plots.

We incorporated 10 qualitative and 7 quantitative studies into our synthesis. The neck pain pooled prevalence was 39% (95% CI: 24-57). Heterogeneity was significant, with 4%-90% prediction interval and I² of 96% (p < 0.001). Subgroup analysis demonstrated a pooled prevalence of 31% (95% CI: 16-53) among the North American population, 51% (95% CI: 28-74) in European countries, 28% (95% CI: 11-54) among veterans and 49% (95% CI: 31-67) among the general population.

Neck pain is common among UULAs; variations are noted across the general population and veterans, as per geography and increased sample size of the population. Physical therapists and other rehabilitative team members should be aware of this neck pain burden. We need improved design and implementation of strategies to reduce the overall neck pain burden among the targeted population.