# Identifying the magnitude and impact of pelvic floor disorders in Veterans with lower limb amputation

> **NIH VA I21** · VA MEDICAL CENTER - LEXINGTON, KY · 2024 · —

## Abstract

Pelvic floor disorders (PFDs) is the broad term used to describe a number of impairments that affect millions of
women and men in the U.S. Symptoms of PFDs resulting from over- or underactivity of pelvic musculature
manifest in a variety of ways, including urinary and fecal incontinence, urinary frequency or urgency, as well
sexual dysfunction and pelvic pain syndromes. Pelvic floor disorders are poorly understood in people with
physical disabilities, and Veterans with lower limb amputation (LLA) are one such group of individuals. Pelvic
floor disorders are effectively managed with conservative, non-pharmacological treatment, but left undiagnosed
can adversely affect many facets of functioning and well-being. People with LLA frequently exhibit conditions
associated with PFDs in the non-LLA population, including low back pain and heightened fall risk, yet the
presence of PFDs have not been systematically assessed in individuals with LLA. With over a million people
living with LLA in the U.S., this may pose a significant health burden that is currently not being addressed. The
overall objective of this proposal is to better understand the magnitude and impact of PFDs on health-related
quality of life in Veterans with LLA. We will explore the prevalence of PFDs amongst men and women with LLA
and the physical and behavioral sequalae associated with the presence of symptoms of PFDs. We propose to
comprehensively address the gaps in knowledge by administering surveys, including psychometrically sound
outcome measures, to assess symptoms of PFDs, to 200 study participants of both sexes (n ≥ 100 females). All
surveys will be remotely administered to participants, to optimize convenience and study enrollment. Our
proposed study has three aims:
Specific Aim 1: To estimate the prevalence of PFDs in a cohort of male and female Veterans with LLA.
This descriptive aim will provide seminal data on the magnitude of PFDs in Veterans with LLA and can serve as
a proxy estimate for rates in the LLA population in general. Estimates will be provided based on sex and level of
LLA (trantibial, transfemoral, etc.) The primary measure of PFD symptoms will be the Pelvic Floor Distress
Inventory (PFDI-20), with secondary measures administered to explore other aspects related to PFDs in men
and women. Furthermore, this aim will assess the feasibility of collecting self-reported pelvic/urogenital
information and the acceptability by Veterans to PFD-related survey items.
Specific Aim 2: To examine associations between PFDs and low back pain, and prosthetic mobility in
Veterans with LLA. This aim is designed to determine physical sequelae related to the presence of PFDs. We
expect that (2A) there will be significant relationships between PFDs and scores on the Oswestry Disability Index
as a measure of low back pain, and (2B) lower scores of prosthetic mobility, as measured by the Prosthetic Limb
Users Survey of Mobility™ will be associated with PFDs.
Specific Aim 3: To examine ...

## Key facts

- **NIH application ID:** 10745327
- **Project number:** 5I21RX003872-02
- **Recipient organization:** VA MEDICAL CENTER - LEXINGTON, KY
- **Principal Investigator:** Sheila M Clemens
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2022-12-01 → 2024-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10745327

## Citation

> US National Institutes of Health, RePORTER application 10745327, Identifying the magnitude and impact of pelvic floor disorders in Veterans with lower limb amputation (5I21RX003872-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10745327. Licensed CC0.

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