{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:59:01Z","timestamp":1788235141271,"version":"build-2803163510"},"reference-count":55,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T00:00:00Z","timestamp":1666828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["T32HD007490"],"award-info":[{"award-number":["T32HD007490"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009713","name":"Foundation for Physical Therapy","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009713","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Among adults with persistent post\u2010amputation pain, increased amputated\u2010region pain sensitivity may reflect peripheral sensitization or indicate underlying central sensitization. To determine whether underlying central sensitization may contribute to increased pain sensitivity in this population, this study compared clinical signs and symptoms associated with central sensitization between adults with post\u2010amputation pain who demonstrate or lack increased amputated\u2010region sensitivity (as compared to reference data).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross\u2010sectional.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects<\/jats:title><jats:p>Ninety\u2010nine adults (60 with a unilateral, transtibial amputation and post\u2010amputation pain, 39 pain\u2010free controls with intact limbs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants underwent pain\u2010pressure threshold testing of amputated\u2010region and secondary (non\u2010amputated region) sites and completed outcome measures assessing central sensitization symptoms (Patient\u2010Reported Outcomes Measurement Information System\u00ae pain intensity and interference domains, Central Sensitization Inventory). Among the full sample, the presence and frequency of specific central sensitization symptoms were evaluated. Participants with post\u2010amputation pain were then grouped based on whether normalized, amputated\u2010region pain\u2010pressure thresholds fell below (i.e., sensitive) or above (i.e., non\u2010sensitive) the 25th percentile of sex\u2010specific reference data. Between\u2010group differences in normalized secondary\u2010site sensitivity were evaluated using a multivariate analysis of variance; central sensitization symptom scores were compared using a Kruskal\u2013Wallis test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Noteworthy symptoms associated with central sensitization (e.g., fatigue, sleep disturbance, cognitive difficulty) were reported by 33%\u201362% of participants. Secondary\u2010site pain sensitivity was greater among individuals with increased amputated\u2010region sensitivity (<jats:italic>n<\/jats:italic>\u00a0=\u00a024) compared to peers without increased amputated\u2010region sensitivity ([<jats:italic>n<\/jats:italic>\u00a0=\u00a036], mean difference\u2009&gt;\u20091.33 standard deviation [SD], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Central sensitization symptom scores, however, were similar between groups (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.187).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Participants with increased amputated\u2010region sensitivity demonstrate generalized, secondary\u2010site pain hypersensitivity, potentially indicating underlying central sensitization. Central sensitization symptom scores, however, were similar between groups, suggesting differences in physiological pain sensitivity may not manifest in subjective post\u2010amputation pain descriptions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.13172","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T13:50:41Z","timestamp":1666014641000},"page":"155-166","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["<scp>Post\u2010amputation<\/scp> pain: Comparing pain presentations between adults with and without increased <scp>amputated\u2010region<\/scp> sensitivity"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0701-5144","authenticated-orcid":false,"given":"Emma Haldane","family":"Beisheim\u2010Ryan","sequence":"first","affiliation":[{"name":"University of Delaware Department of Physical Therapy  Newark Delaware USA"},{"name":"VA Eastern Colorado Geriatric Research, Education, and Clinical Center (GRECC), VA Eastern Colorado Health Care System  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8385-8218","authenticated-orcid":false,"given":"Ryan Todd","family":"Pohlig","sequence":"additional","affiliation":[{"name":"University of Delaware Biostatistics Core  Newark Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8611-994X","authenticated-orcid":false,"given":"Gregory\u00a0Evan","family":"Hicks","sequence":"additional","affiliation":[{"name":"University of Delaware Department of Physical Therapy  Newark Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Robert","family":"Horne","sequence":"additional","affiliation":[{"name":"Independence Prosthetics\u2010Orthotics, Inc.  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