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Published in: Systematic Reviews 1/2019

Open Access 01-12-2019 | Protocol

The prevalence of phantom limb pain and associated risk factors in people with amputations: a systematic review protocol

Authors: Katleho Limakatso, Gillian J. Bedwell, Victoria J. Madden, Romy Parker

Published in: Systematic Reviews | Issue 1/2019

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Abstract

Background

The prevalence of phantom limb pain (PLP) in people with amputations is unclear because of the conflicting reports across the literature. It is proposed that the conflicting reports on the prevalence of PLP are a consequence of variations in the time period during which the studies were undertaken, countries in which the studies were conducted and recruitment processes implemented during collection of epidemiological data. In consideration of these factors, we aim to gather and critically appraise relevant literature to determine the prevalence estimate of and risk factors for PLP in people with amputations.

Methods

We will use a customised search strategy containing relevant words and terms to search the following databases: MEDLINE/PubMed (via EBSCOhost), PsycINFO (via EBSCOhost), PsycArticles, Cumulative Index to Nursing and Allied Health Literature (CINAHL) (via EBSCOhost), Africa-Wide Information (via EBSCOhost), Health Source: Nursing/Academic Edition (via EBSCOhost) SCOPUS, Web of Science and Academic Search Premier (via EBSCOhost). The risk of bias assessment will be conducted using a risk of bias assessment tool for prevalence studies, and data will be extracted using a piloted customised data extraction sheet. Data extracted from individual studies will be entered into Review Manager 5 and assessed for clinical and statistical heterogeneity. Studies will be pooled for meta-analysis using the random-effects model to determine a summary estimate of the prevalence of PLP across included studies. A statistically significant level will be set at p < 0.05.

Discussion

As far as we know, a systematic review and meta-analysis on the prevalence of, and risk factors for PLP in people with amputations has not been conducted. Given the varying reports in the literature, it is necessary to determine an estimate of the prevalence of PLP to generate an informed conclusion on this subject. The results of this review will be published in an internationally accredited journal and used to inform researchers, clinicians, policy-makers and the public about the burden of, and risk factors for PLP. This will be done with a further aim to improve the quality of pain management in society.

Systematic review registration

Appendix
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Literature
1.
go back to reference Ehde DM, Czerniecki JM, Smith DG, Campbell KM, Edwards WT, Jensen MP, et al. Chronic phantom sensations, phantom pain, residual limb pain, and other regional pain after lower limb amputation. Arch Phys Med Rehabil. 2000;81(8):1039–44.CrossRef Ehde DM, Czerniecki JM, Smith DG, Campbell KM, Edwards WT, Jensen MP, et al. Chronic phantom sensations, phantom pain, residual limb pain, and other regional pain after lower limb amputation. Arch Phys Med Rehabil. 2000;81(8):1039–44.CrossRef
2.
go back to reference Melzack R, Israel R, Lacroix R, Schultz G. Phantom limbs in people with congenital limb deficiency or amputation in early childhood. Brain J Neurol. 1997;120(9):1603–20.CrossRef Melzack R, Israel R, Lacroix R, Schultz G. Phantom limbs in people with congenital limb deficiency or amputation in early childhood. Brain J Neurol. 1997;120(9):1603–20.CrossRef
3.
go back to reference Saadah E, Melzack R. Phantom limb experiences in congenital limb-deficient adults. Cortex. 1994;30(3):479–85.CrossRef Saadah E, Melzack R. Phantom limb experiences in congenital limb-deficient adults. Cortex. 1994;30(3):479–85.CrossRef
4.
go back to reference Dijkstra PU, Geertzen JH, Stewart R, van der Schans CP. Phantom pain and risk factors: a multivariate analysis. J Pain Symptom Manage. 2002;24(6):578–85.CrossRef Dijkstra PU, Geertzen JH, Stewart R, van der Schans CP. Phantom pain and risk factors: a multivariate analysis. J Pain Symptom Manage. 2002;24(6):578–85.CrossRef
5.
go back to reference Alviar M, Hale T, Dungca M. Pharmacologic interventions for treating phantom limb pain. Cochrane Database Syst Rev. 2011;12:CD006380. Alviar M, Hale T, Dungca M. Pharmacologic interventions for treating phantom limb pain. Cochrane Database Syst Rev. 2011;12:CD006380.
6.
go back to reference Padovani MT, Martins MRI, Venâncio A, Forni JEN. Anxiety, depression and quality of life in individuals with phantom limb pain. Acta Ortop Bras. 2015;23(2):107–10.CrossRef Padovani MT, Martins MRI, Venâncio A, Forni JEN. Anxiety, depression and quality of life in individuals with phantom limb pain. Acta Ortop Bras. 2015;23(2):107–10.CrossRef
7.
go back to reference Morgan SJ, Friedly JL, Amtmann D, Salem R, Hafner BJ. Cross-sectional assessment of factors related to pain intensity and pain interference in lower limb prosthesis users. Arch Phys Med Rehabil. 2017;98(1):105–13.CrossRef Morgan SJ, Friedly JL, Amtmann D, Salem R, Hafner BJ. Cross-sectional assessment of factors related to pain intensity and pain interference in lower limb prosthesis users. Arch Phys Med Rehabil. 2017;98(1):105–13.CrossRef
8.
go back to reference Sherman RA, Sherman CJ. Prevalence and characteristics of chronic phantom limb pain among American veterans: results of a trial survey. Am J Phys Med Rehab. 1983;62(5):227–38. Sherman RA, Sherman CJ. Prevalence and characteristics of chronic phantom limb pain among American veterans: results of a trial survey. Am J Phys Med Rehab. 1983;62(5):227–38.
9.
go back to reference Parkes CM. Factors determining the persistence of phantom pain in the amputee. J Psychosom Res. 1973;17(2):97–108.CrossRef Parkes CM. Factors determining the persistence of phantom pain in the amputee. J Psychosom Res. 1973;17(2):97–108.CrossRef
10.
go back to reference Ahmed A, Bhatnagar S, Mishra S, Khurana D, Joshi S, Ahmad SM. Prevalence of phantom limb pain, stump pain, and phantom limb sensation among the amputated cancer patients in India: a prospective, observational study. Indian J Palliat Care. 2017;23(1):24.CrossRef Ahmed A, Bhatnagar S, Mishra S, Khurana D, Joshi S, Ahmad SM. Prevalence of phantom limb pain, stump pain, and phantom limb sensation among the amputated cancer patients in India: a prospective, observational study. Indian J Palliat Care. 2017;23(1):24.CrossRef
11.
go back to reference Maimela E, Alberts M, Modjadji SE, Choma SS, Dikotope SA, Ntuli TS, et al. The prevalence and determinants of chronic non-communicable disease risk factors amongst adults in the Dikgale health demographic and surveillance system (HDSS) site, Limpopo Province of South Africa. PLoS One. 2016;11(2):e0147926.CrossRef Maimela E, Alberts M, Modjadji SE, Choma SS, Dikotope SA, Ntuli TS, et al. The prevalence and determinants of chronic non-communicable disease risk factors amongst adults in the Dikgale health demographic and surveillance system (HDSS) site, Limpopo Province of South Africa. PLoS One. 2016;11(2):e0147926.CrossRef
12.
go back to reference Jensen TS, Krebs B, Nielsen J, Rasmussen P. Immediate and long-term phantom limb pain in amputees: incidence, clinical characteristics and relationship to pre-amputation limb pain. Pain. 1985;21(3):267–78.CrossRef Jensen TS, Krebs B, Nielsen J, Rasmussen P. Immediate and long-term phantom limb pain in amputees: incidence, clinical characteristics and relationship to pre-amputation limb pain. Pain. 1985;21(3):267–78.CrossRef
13.
go back to reference Mishra S, Bhatnagar S, Gupta D, Diwedi A. Incidence and management of phantom limb pain according to World Health Organization analgesic ladder in amputees of malignant origin. Am J Hos Palliat Med. 2008;24(6):455–62.CrossRef Mishra S, Bhatnagar S, Gupta D, Diwedi A. Incidence and management of phantom limb pain according to World Health Organization analgesic ladder in amputees of malignant origin. Am J Hos Palliat Med. 2008;24(6):455–62.CrossRef
14.
go back to reference Byrne KPA. Survey of phantom limb pain, phantom sensation and stump pain in Cambodian and New Zealand amputees. Pain Med. 2011;12(5):794–8.CrossRef Byrne KPA. Survey of phantom limb pain, phantom sensation and stump pain in Cambodian and New Zealand amputees. Pain Med. 2011;12(5):794–8.CrossRef
15.
go back to reference Sherman RA, Sherman CJ, Gall NG. A survey of current phantom limb pain treatment in the United States. Pain. 1980;8(1):85–99.CrossRef Sherman RA, Sherman CJ, Gall NG. A survey of current phantom limb pain treatment in the United States. Pain. 1980;8(1):85–99.CrossRef
16.
go back to reference Desmond DM, MacLachlan M. Prevalence and characteristics of phantom limb pain and residual limb pain in the long term after upper limb amputation. Int J Rehabil Res. 2010;33(3):279–82.CrossRef Desmond DM, MacLachlan M. Prevalence and characteristics of phantom limb pain and residual limb pain in the long term after upper limb amputation. Int J Rehabil Res. 2010;33(3):279–82.CrossRef
17.
go back to reference Ventham N, Heyburn P, Huston N. 374 prevalence of phantom limb pain in diabetic and non-diabetic leg amputees: a cross-sectional observational survey. Eur J Pain Suppl. 2010;4(1):106–7.CrossRef Ventham N, Heyburn P, Huston N. 374 prevalence of phantom limb pain in diabetic and non-diabetic leg amputees: a cross-sectional observational survey. Eur J Pain Suppl. 2010;4(1):106–7.CrossRef
18.
go back to reference Moloi AH, Watkins D, Engel ME, Mall S, Zühlke L. Epidemiology, health systems and stakeholders in rheumatic heart disease in Africa: a systematic review protocol. BMJ Open. 2016;6(5):e011266.CrossRef Moloi AH, Watkins D, Engel ME, Mall S, Zühlke L. Epidemiology, health systems and stakeholders in rheumatic heart disease in Africa: a systematic review protocol. BMJ Open. 2016;6(5):e011266.CrossRef
19.
go back to reference Richardson C, Kulkarni J. A review of the management of phantom limb pain: challenges and solutions. J Pain Res. 2017;10:1861–70.CrossRef Richardson C, Kulkarni J. A review of the management of phantom limb pain: challenges and solutions. J Pain Res. 2017;10:1861–70.CrossRef
20.
go back to reference Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, Group, Prisma-P, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;349:7647.CrossRef Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, Group, Prisma-P, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;349:7647.CrossRef
21.
go back to reference Sideri S, Papageorgiou SN, Eliades T. Registration in the international prospective register of systematic reviews (PROSPERO) of systematic review protocols was associated with increased review quality. J Clin Epidemiol. 2018;100:103–10. Sideri S, Papageorgiou SN, Eliades T. Registration in the international prospective register of systematic reviews (PROSPERO) of systematic review protocols was associated with increased review quality. J Clin Epidemiol. 2018;100:103–10.
22.
go back to reference Rathvon D. EndNote X8--citation manager--What's new? 2017. Rathvon D. EndNote X8--citation manager--What's new? 2017.
23.
go back to reference Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, et al. Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol. 2012;65(9):934–9.CrossRef Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, et al. Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol. 2012;65(9):934–9.CrossRef
24.
go back to reference The Nordic Cochrane Centre. The Cochrane collaboration. Review manager (RevMan). 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration; 2011. The Nordic Cochrane Centre. The Cochrane collaboration. Review manager (RevMan). 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration; 2011.
25.
go back to reference Gagnier JJ, Moher D, Boon H, Beyene J, Bombardier C. Investigating clinical heterogeneity in systematic reviews: a methodologic review of guidance in the literature. BMC Med Res Methodol. 2012;12(1):111.CrossRef Gagnier JJ, Moher D, Boon H, Beyene J, Bombardier C. Investigating clinical heterogeneity in systematic reviews: a methodologic review of guidance in the literature. BMC Med Res Methodol. 2012;12(1):111.CrossRef
26.
go back to reference Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ: Br Med J. 2003;327(7414):557.CrossRef Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ: Br Med J. 2003;327(7414):557.CrossRef
27.
go back to reference Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34.CrossRef Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34.CrossRef
28.
go back to reference Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960;20(1):37–46.CrossRef Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas. 1960;20(1):37–46.CrossRef
30.
go back to reference Rommers G, Vos L, Groothoff J, Schuiling C, Eisma W. Epidemiology of lower limb amputees in the north of the Netherlands: aetiology, discharge destination and prosthetic use. Prosthetics Orthot Int. 1997;21(2):92–9. Rommers G, Vos L, Groothoff J, Schuiling C, Eisma W. Epidemiology of lower limb amputees in the north of the Netherlands: aetiology, discharge destination and prosthetic use. Prosthetics Orthot Int. 1997;21(2):92–9.
31.
go back to reference Unwin N. Epidemiology of lower extremity amputation in centres in Europe, North America and East Asia. Br J Surg. 2000;87(3):328–37.CrossRef Unwin N. Epidemiology of lower extremity amputation in centres in Europe, North America and East Asia. Br J Surg. 2000;87(3):328–37.CrossRef
32.
go back to reference Esquenazi A. Amputation rehabilitation and prosthetic restoration. From surgery to community reintegration. Disabil Rehabil. 2004;26(14–15):831–6.CrossRef Esquenazi A. Amputation rehabilitation and prosthetic restoration. From surgery to community reintegration. Disabil Rehabil. 2004;26(14–15):831–6.CrossRef
33.
go back to reference Godlwana L, Nadasan T, Puckree T. Global trends in incidence of lower limb amputation: a review of the literature. South Afr J Physiotherapy. 2008;64(1):8–12. Godlwana L, Nadasan T, Puckree T. Global trends in incidence of lower limb amputation: a review of the literature. South Afr J Physiotherapy. 2008;64(1):8–12.
34.
go back to reference Staats T. The rehabilitation of the amputee in the developing world: a review of the literature. Prosthetics Orthot Int. 1996;20(1):45–50. Staats T. The rehabilitation of the amputee in the developing world: a review of the literature. Prosthetics Orthot Int. 1996;20(1):45–50.
35.
go back to reference Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924–6.CrossRef Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924–6.CrossRef
Metadata
Title
The prevalence of phantom limb pain and associated risk factors in people with amputations: a systematic review protocol
Authors
Katleho Limakatso
Gillian J. Bedwell
Victoria J. Madden
Romy Parker
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2019
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-018-0938-8

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