Incidence of Upper Extremity Nerve Entrapments in Veterans with Major Limb Amputations

Principle Investigator: Rory Cooper, Ph.D.

2008-2009

The objective of this research study is to collect pilot data on the incidence of nerve entrapments of the upper extremities in soldiers/veterans with major limb loss. This information is needed to guide the development and evaluation of prevention and treatment approaches.

The study population will be comprised of up to 30 veterans or active duty soldiers with a major limb amputation.  The subjects will be participants at the National Disabled Veterans Winter Sports Clinics at Snowmass, Colorado.  All subjects will be aged 18 and over and use assistive technology, such as a wheelchair or prosthesis, for mobility or to assist with activities of daily living.  Subjects will complete a questionnaire, and undergo an upper extremity physical exam and nerve conduction studies. A physician(s) board certified in Physical Medicine and Rehabilitation will be performing the nerve conduction studies.  Total testing time is expected to be a maximum of 3 hours.

Individuals with lower extremity amputations rely heavily on their upper extremities for mobility.  There is different exposure during the various phases of rehabilitation on into community reintegration (to include return to active duty).  Both manual wheelchair propulsion and crutch ambulation have been implicated in upper limb repetitive strain injuries. Individuals with upper extremity amputations rely heavily on their intact upper limb for activities of daily living. Overuse and repetitive strain are implicated in upper extremity nerve entrapment syndromes. Individuals with disabilities have reported that acquiring a repetitive strain injury is similar to having a more severe disability, and that the accompanying pain is one of the most significant factors related to self-reported quality of life.