Long-Term Follow-Up of prosthetic rehabilitation programs for chronic low back pain

Ingrid Pedersen; B. Hansen; E. Lindqvist

doi:10.5281/zenodo.22815131

Authors

Ingrid Pedersen Department of Rehabilitation Research, Seine Institute of Physical Medicine Author https://orcid.org/4601-1665-1027-569X
B. Hansen Department of Clinical Rehabilitation Research, Congo Academy of Rehabilitation Research Author https://orcid.org/3611-2809-4011-7916
E. Lindqvist Department of Physical Medicine, Volga Research Center for Rehabilitation Research Author https://orcid.org/9366-1138-6637-1364

DOI:

https://doi.org/10.5281/zenodo.22815131

Keywords:

amputation, prosthetic rehabilitation, chronic low back pain, gait asymmetry, long-term follow-up

Abstract

Graphical abstract

Background: Lower-limb amputation redistributes load onto the lumbar spine and residual limb, and chronic low back pain affects a substantial share of prosthesis users at long-term follow-up, with prevalence commonly exceeding half of amputee cohorts.

Objective: This review synthesizes long-term follow-up evidence on structured prosthetic rehabilitation programs, including gait retraining, socket/alignment optimization, and core-stabilization exercise, and their effect on chronic low back pain in lower-limb amputees.

Methods: We synthesized cohort studies, gait-biomechanics analyses, and rehabilitation-program follow-up reports addressing compensatory lumbar loading, gait asymmetry, socket fit, and exercise interventions in transtibial and transfemoral amputees.

Findings: Compensatory gait asymmetry and pelvic obliquity increase lumbar load and correlate with pain severity; alignment and socket-fit optimization reduce asymmetry and pain scores; and multi-year follow-up of structured rehabilitation, including core-stabilization and gait-retraining, is associated with durable reductions in pain and disability index scores, with effect sizes varying by amputation level and adherence.

Conclusions: Long-term prosthetic rehabilitation combining biomechanical gait correction, individualized socket/alignment adjustment, and sustained core-stabilization exercise is associated with meaningful, durable reductions in chronic low back pain, supporting spine-directed rehabilitation as a routine part of long-term prosthetic follow-up care.

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