Lower Extremity Functional Scale Research Articles

Surgical outcome of angular deformity correction of lower limbs in rickets: a cross-sectional study.

This study aims to compare the functional and radiological outcomes following both guided growth surgery (GGS) and acute corrective osteotomy (ACO) correction of angular deformities in children with rickets. A total of 8 and 7 children who had gradual GGS and ACO correction, respectively, for angular deformities due to rickets from 2002 to 2022 were recalled for follow-up. Demographic data, types of rickets, data on pharmacological treatment, biochemical parameters, recurrence of angular deformity and postoperative complications were obtained from the medical records. A radiographic evaluation of the leg was performed to determine the tibiofemoral angle. For functional evaluation, the Active Scale for Kids (ASK) and Lower Extremity Functional Scale (LEFS) instruments were used for children below and above 15years old, respectively. In terms of the tibiofemoral angle, the GGS group documented greater angle changes compared to the ACO group, but the difference was not significant. In terms of functional outcomes, the overall score percentage of both groups was comparable with the GGS group showing a trend of higher score percentage compared to the ACO group. The GGS group presented no complication while 2 neurovascular injuries and 1 implant failure were recorded in the ACO group. Both GGS and ACO procedures resulted in similar radiographic and functional outcomes for the treatment of rickets in children. GGS may be advantageous in terms of reducing complications of surgery. Nevertheless, the choice of surgical intervention should be made based on the patient's circumstances and the surgeon's preference.

Validity and Reliability of the Lower Extremity Motor Coordination Test (LEMOCOT) in Patients with Multiple Sclerosis

The validity and reliability of the Lower Extremity Motor Coordination Test (LEMOCOT) were assessed in patients with multiple sclerosis (MS). The study involved 60 participants diagnosed with MS (mean age: 48.13 years, range: 24–80 years). Intra-rater reliability was assessed within-day (n = 12), and inter-rater reliability was assessed within-day (n = 45) and between-days (n = 22). For known-groups validity, test scores were compared between participants of different sexes; for convergent validity, test scores were correlated with age, the Five-Repetition Sit-to-Stand test (FSTS), the Berg Balance Scale (BBS), the Lower Extremity Functional Scale (LEFS), and the Expanded Disability Status Scale (EDSS). To test the discriminant validity, the LEMOCOT test scores were correlated with the Mini-Mental State Evaluation (MMSE) and compared according to social history (living alone or not). The LEMOCOT test was tested under three different conditions and found to be very reliable (intraclass correlation coefficient, ICC2,1 > 0.94) with an acceptable error level (standard error of the measurement, SEM, between 1.39 and 3.47 targets and 95% minimum detectable change; MDC95%, between 3.84 and 9.58 targets). Convergent validity was verified, as the LEMOCOT registered very strong correlations with the FSTS test (r = −0.851) and the BBS scale (r = 0.815), a strong correlation with the LEFS scale (r = 0.78), a moderate correlation with the EDSS scale (r = −0.634), all highly significant (p < 0.001), and a weak correlation with age (r = −0.332, p < 0.01). Discriminant validity was also confirmed, as the LEMOCOT demonstrated a weak correlation with the MMSE scale (r = 0.365, p = 0.017) and no differences relative to living environment or sex. The LEMOCOT demonstrated excellent reliability and validity for patients with MS.

Effect of a Manual Lymphatic Drainage with Rehabilitation Exercise on Edema, Pain, And Lower Extremity Function in Gynecological Cancer After Surgery

This study aimed to determine the effects of manual lymphatic drainage with rehabilitation exercises on edema, pain, and lower extremity function in patients with gynecological cancer after surgery. The study included 20 patients with gynecological cancer with a Numeric Rating Scale (NRS) pain score >3, who were either inpatients or outpatients in Seoul. The patients were randomly assigned to either the experimental group (n=10) or control group (n=10). The experimental group underwent manual lymphatic drainage with rehabilitation exercises, whereas the control group underwent manual lymphatic drainage with diaphragmatic breathing. Each patient was treated for 50 min twice a week for 4 weeks. Before and after the experiment, edema, pain, lower extremity function, and quality of life were evaluated using the Circumference Tape, Numeric Rating Scale, Lower Extremity Functional Scale, and Memorial Symptom Assessment Scale. The results of this study were as follows. First, the edema between the experimental and control groups significantly decreased before and after the intervention; however, there was no significant difference in the comparison between the groups. Second, the pain scores between the experimental and control groups significantly decreased before and after the intervention, and there was a significant difference in the comparison between the groups. Third, the lower extremity function between the experimental and control groups significantly increased before and after the intervention, and there was no significant difference between the groups. Forth, the quality of life between the experimental and control groups significantly increased before and after the intervention, and there was significant difference in the comparison between the group. The physical symptoms were significantly different between the groups; however, the emotional symptoms were not. The analysis of this experiment showed that, both the groups were effective in improving edema, pain, lower extremity function, and quality of life in patients with gynecological cancer undergoing surgery. In particular, manual lymphatic drainage with rehabilitation exercises was more effective than manual lymphatic drainage with diaphragmatic breathing for edema and physical symptoms of patients with gynecological cancer after surgery.

Quality of Life After Lower Leg Reconstruction With the Latissimus Dorsi Free Flap in Pediatric Patients.

The latissimus dorsi free flap is a widely used reconstructive technique for complex lower leg defects in the pediatric population due to its reliability and anatomical features. However, the impact of this technique on the postoperative quality of life in children and adolescents, who require appropriate lower extremity function during their developmental period, remains to be analyzed. Patients who underwent microsurgical lower leg reconstruction using the latissimus dorsi flap were analyzed retrospectively. The quality of life of these patients was assessed prospectively using the Lower Extremity Functional Scale (LEFS) at a minimum of 18 months after surgical reconstruction. Sixteen pediatric patients who had severe lower extremity injuries and underwent latissimus dorsi free flap reconstruction met the inclusion criteria. The mean follow-up period was 33.9 months (22-64 months). Two patients experienced postoperative complications: one had partial flap necrosis and surgical site infection, while the other developed a surgical site infection. The LEFS scores ranged from 26 to 80, with a mean score of 64.6. Remarkably, 14 of 16 patients achieved LEFS scores consistent with at least the 10th percentile when compared with normative data. Patients with severe associated fractures presented with the lowest scores. Based on our findings, the latissimus dorsi flap is reaffirmed to be an excellent choice for lower leg reconstruction in the pediatric population. It effectively restores the quality of life in patients who have experienced moderate to severe lower extremity injuries.

Combined Hip and Knee Strengthening Compared With Knee Strengthening for Individuals With Lateral Patellar Dislocation: A Single-blind, Superiority, Randomized Controlled Trial

ObjectiveTo investigate whether a combined hip and knee muscle strengthening program is superior to a knee strengthening program for people after lateral patellar dislocation (LPD). DesignSingle-blind, superiority, randomized controlled trial with 48 weeks follow-up. SettingPhysiotherapy out-patient clinic. ParticipantsForty individuals aged 16 or older, with a history of non-traumatic LPD were randomized to a knee-based strengthening (KBSG) or quadriceps and hip strengthening exercise (HQSG) program (N=40). Inclusion criteria included a positive apprehension sign, pain on palpation along the medial retinaculum, and J sign. Exclusion criteria included restricted range of motion (<90° knee flexion), and traumatic or postsurgical LPD. InterventionsConcealed randomization was performed using random permuted blocks of size 4. Individuals received their corresponding exercise program according to randomization and group allocation: knee-based strengthening (n=20) or combined hip and quadriceps strengthening (n=20) twice weekly for 8 weeks over 16 appointments. Main Outcome MeasuresPrimary outcome was the Lysholm Knee Score. Secondary outcomes included Numerical Pain Ratings Scale (NPRS) at rest and during effort, Norwich Patellar Instability Score (NPIS), Kujala Anterior Knee Pain Scale (AKPS), Lower Extremity Functional Scale (LEFS), 4 domains of the WHOQOL-Bref, and recurrence rate. Patient-reported outcome measures were assessed from the baseline to 48 weeks. Assessments were performed by a physiotherapist who was blinded to the group allocation. Data were analyzed by using a repeated-measures ANOVA model with Tukey's post hoc test after an intention-to-treat principle. ResultsAt the primary time-point of 8 weeks, there were no substantial between-group differences in the Lysholm Knee Score: mean difference=-6.8 (95% CI -14.3 to 3.7); NPIS: mean difference=23.5 (95% CI 5.6 to 41.3); AKPS: mean difference=-1.54 (95% CI -8.6 to 5.6), NPRS at rest and during effort (mean difference=0.32 (95% CI -0.37 to 1); and mean difference=0.68 (95% CI -0.9 to 1.86); LEFS mean difference=-1.08 (95% CI -5.9 to 2.4), WHOQOL-Bref domains (physical health: mean difference=-0.12, (95% CI -1.26 to 1.02); psychological: mean difference=-0.32 (95% CI -2.04 to 1.4); social relations: mean difference=-0.7 (95% CI -2.2 to 0.82); environment: mean difference=0.44 (95% CI -1 to 1.9), and recurrence rate (P=.69). ConclusionThis study indicates that combined hip and knee muscle strengthening is not superior to knee-based strengthening for LPD treatment. The limitations stemming from the underpowered nature of the trial must be acknowledged, concerning the potential oversight of moderate intervention effects.

Comparative study of retrograde intramedullary nailing versus locking extramedullary plating in complete articular fractures with metaphyseal comminution of the distal femur.

Fractures of the distal femur with metaphyseal comminution and complete intra-articular involvement (AO/OTA classifications 33C2 and 33C3) present challenges for reduction and fixation. However, an optimal fixation method remains unknown. This study aimed to compare the clinical and radiographic outcomes of locking extramedullary plating (LEP) and retrograde intramedullary nailing (RIN) for complete distal femoral intra-articular fractures with metaphyseal comminution. Between January 2016 and May 2022, 80 patients (45 men and 35 women; average age, 56.7 years) diagnosed with AO/OTA 33C2 and 33C3 were treated with either LEP or RIN and followed up for at least one year. Post-operative evaluations included radiographic assessments of bone union rate, timing, and alignment. Clinically, the knee joint range of motion (ROM), lower extremity functional scale (LEFS), and Kellgren and Lawrence (KL) grade were analyzed. The complications were also compared. 36 underwent LEP and 44 underwent RIN. Bone union was observed in 69.4% and 63.6% of the patients in the LEP and RIN groups, respectively (p = 0.64). The average union time was 6.9 months for the LEP group and 6.6 months for the RIN group (p = 0.51). A tendency toward varus deformity was observed in the RIN group, although the difference was not statistically significant. No significant differences were observed in knee ROM, LEFS, or KL grade. Complications included non-union (33.8%; RIN, 11; LEP, 16), varus deformity (5%; RIN, 4; LEP, 0), infection (1.3%; RIN, 0; LEP, 1), heterotrophic ossification (1.3%; RIN, 0; LEP, 1), and wound dehiscence (2.5%; RIN, 2; LEP, 0). The surgical fixation methods, RIN and LEP, for complete distal femoral intra-articular fractures with metaphyseal comminution showed similar clinical and radiological outcomes. However, regardless of the type of fixation device used, there was a reduced rate of bone union owing to high energy and a less favorable prognosis.

Comparison of Self-Reported and Capacity-Based Measures of Mobility in Community-Dwelling Older Adults in Nigeria: The Mediating Role of Age, Cognitive Status, and Chronic Conditions.

Although the association between self-reported and capacity-based mobility outcomes is prominently researched, the pathways through which self-reported measures affect capacity-based measures remains poorly understood. Therefore, our study examines the association between self-reported and capacity-based mobility measures and explores which mobility determinants mediate the association in Nigerian community-dwelling older adults. This cross-sectional study included 169 older adults [mean age (SD) = 67.7 (7.0)]. Capacity-based mobility outcomes included the Short Physical Performance Battery (SPPB), the 6-Minute Walk Test (6MWT), and the 10-Meter Walk Test (10mWT), whereas the self-reported mobility outcomes included the Lower Extremity Functional scale (LEFS), the Life Space Questionnaire (LSQ), and the Mänty Preclinical Mobility scale (inability to walk 2 km, 0.5 km, or climb a flight of stairs). Spearman's correlations were conducted to examine the relationship between self-reported and capacity-based mobility measures, whereas structural equation modeling was used to determine the mediators. The correlation between SPPB and LEFS (rho = 0.284) and 0.5 km (rho = -0.251) were fair, whereas the correlation between SPPB and inability to walk 2 km (rho = -0.244) and inability to climb a flight of stairs (rho = -0.190) were poor. Similarly, correlations between 6MWT and the LEFS (rho = 0.286), inability to walk 2 km (rho = -0.269), and 0.5 km (rho = -0.303) were fair. The 6WMT was poorly correlated with inability to climb one flight of stairs (rho = -0.233). The LSQ was not correlated with SPPB or 10mWT. Age was the only significant mediator, whereas the number of chronic conditions and cognitive status were not. The correlation between self-reported and capacity-based mobility outcomes in older adults in Nigeria is lower than those in developed countries. Our analysis provides a foundation to explore mobility determinants that could be predictive mediators for mobility outcomes, making meaningful contributions to explaining mobility complexities.

Patella Fractures outcome after Tension Band Wiring; a Cross-sectional Study

Objective: The most common technique for fixing patella fractures is tension band wiring (TBW). The current study aimed to assess the functional and radiological outcomes of the patellar fractures treated by TBW. Patients and Methods: This retrospective cohort study was performed on 78 patients who underwent TBW of patellar fracture in Akhtar Orthopedic Hospital, Tehran, Iran, from September 2015 to April 2018 and had completed a two-year follow-up. A surgical intervention consisting of open reduction and internal fixation was performed on all patients using TBW. Patients were evaluated two years postoperatively by clinical examination, radiographic investigation, and three scales (Tegner activity score [TAS], Lysholm knee score [LKS], and lower extremity functional scale [LEFS]). Result: Of the 78 patients, 48 (61.5%) were male, with a mean age of 36.7 13.1 years. Postoperatively, 41 (52.6%) patients had anterior knee pain, and four (5%) patients had an infection. Knee range of motion was limited in 20 (25.6%) patients. The mean postoperative TAS, LKS, and LEFS mean scores were 4.3 1.34, 85.97 9.21, and 69.62 6.68, respectively. Age was inversely correlated with LKS and LEFS, as both scores decreased with increasing age (p 0.001, r:-0.4). Younger patients (under 30 years old) were more likely to reach their pre-injury TAS score than older patients (p 0.001). In addition, patellofemoral osteoarthritis and patella baja were significantly higher in patients with comminuted fractures than in those with simple fracture patterns (p 0.001). Conclusion: We found acceptable outcomes after fixation with TBW, especially in younger patients; LKS and LEFS scores were lower in the elderly, and younger patients were more likely to reach closer to their pre-injury TAS score. Furthermore, patellofemoral osteoarthritis and patella baja were associated with comminuted patella fractures.

Can the Lower Extremity Functional Scale Be Used in Children and Adolescents? A Validation Study.

The lower extremity functional scale (LEFS) is a patient-reported outcome measure for assessment of lower extremity function. It has been validated in adults but not in children or adolescents. Patients 8 to 18 years of age who were treated for a lower limb fracture, injury, or other conditions were invited to join the study. LEFS and Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL) were administered. Reliability and validity of the LEFS were determined for the entire cohort and for 2 age groups (children: 8 to 12 years; adolescents 13 to 18 years) using PedsQL as comparison. A total of 178 patients were recruited into this study. In the entire cohort, internal consistency of LEFS was excellent (0. 972) with acceptable floor (0%) and ceiling (12%) effects. Correlation between LEFS and PedsQL physical functioning component was high ( r =0.859). Construct validity was acceptable, with all 8 hypotheses demonstrating statistical significance. Factor analysis showed that item 15 (sitting for 1 hour) may contribute to measurement error in the pediatric population. Results remained similar when comparing the 2 age groups. The LEFS is overall an acceptable patient-reported outcome assessment of children and adolescents with various lower limbs disorders. Level II.

Treatment of Large Femoral and Tibial Bone Defects With Plate-Assisted Bone Segment Transport.

The purposes of this study were to assess clinical and radiographic outcomes following plate-assisted bone segment transport (PABST) in large bone defects of the lower extremities. Retrospective study of prospectively collected data. Level-1 trauma center located in Germany. Patients who underwent PABST and were at least 1 year postoperatively were included. Demographic data were collected. Radiographic apparent bone gap (RABG), time to consolidation, time to full weight-bearing, and consolidation index were calculated. Numeric rating scale, lower extremity functional scale (LEFS), and complications were assessed. Fifteen patients [13 male; mean age 51 years (range, 20-75)] underwent PABST and had follow-up at a mean of 29.1 months. The tibia was affected in 8 and the femur in 7 patients. Preoperative RABG was 60 mm [interquartile range (IQR): 40-125], and bone defects were caused by septic nonunions in 73% of patients. Fourteen patients (93%) demonstrated consolidated transport callus at 7.3 months [95% confidence interval (95% CI), 6-8.5], and 9 patients (60%) demonstrated complete consolidation of both docking site and transport callus at 11.5 months (95% CI, 7.3-15.3). Postoperative RABG was 0.1 mm (IQR: 0-0.8), and consolidation index was 1.9 months/cm (95% CI, 1.3-2.5). All patients achieved full weight-bearing at 8.7 months (IQR: 6.5-10.3). LEFS was 42 (95% CI, 34-50), and numeric rating scale was 3 (95% CI, 2-4). Patients treated for tibial defects had a significantly higher consolidation rate compared with patients treated for femoral defects ( P = 0.040). PABST demonstrated high consolidation of transport callus with few complications. Although full weight-bearing was achieved in all patients, complete consolidation of the docking site was only present in 60% of cases. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Quantitative Magnetic Resonance Imaging of Lateral Compartment Articular Cartilage After Lateral Extra-articular Tenodesis

Background: Concerns have arisen that anterior cruciate ligament reconstruction (ACLR) with lateral extra-articular tenodesis (LET) may accelerate the development of posttraumatic osteoarthritis in the lateral compartment of the knee. Purpose/Hypothesis: The purpose of this study was to evaluate whether the augmentation of ACLR with LET affects the quality of lateral compartment articular cartilage on magnetic resonance imaging (MRI) at 2 years postoperatively. We hypothesized that there would be no difference in T1rho and T2 relaxation times when comparing ACLR alone with ACLR + LET. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A consecutive subgroup of patients at the Fowler Kennedy Sport Medicine Clinic participating in the STABILITY 1 Study underwent bilateral 3-T MRI at 2 years after surgery. The primary outcome was T1rho and T2 relaxation times. Articular cartilage in the lateral compartment was manually segmented into 3 regions of the tibia (lateral tibia [LT]–1 to LT-3) and 5 regions of the femur (lateral femoral condyle [LFC]–1 to LFC-5). Analysis of covariance was used to compare relaxation times between groups, adjusted for lateral meniscal tears and treatment, cartilage and bone marrow lesions, contralateral relaxation times, and time since surgery. Semiquantitative MRI scores according to the Anterior Cruciate Ligament OsteoArthritis Score were compared between groups. Correlations were used to determine the association between secondary outcomes (including results of the International Knee Documentation Committee score, Knee injury and Osteoarthritis Outcome Score, Lower Extremity Functional Scale, 4-Item Pain Intensity Measure, hop tests, and isokinetic quadriceps and hamstring strength tests) and cartilage relaxation. Results: A total of 95 participants (44 ACLR alone, 51 ACLR + LET) with a mean age of 18.8 years (61.1% female [58/95]) underwent 2-year MRI (range, 20-36 months). T1rho relaxation times were significantly elevated for the ACLR + LET group in LT-1 (37.3 ± 0.7 ms vs 34.1 ± 0.8 ms, respectively; P = .005) and LFC-2 (43.9 ± 0.9 ms vs 40.2 ± 1.0 ms, respectively; P = .008) compared with the ACLR alone group. T2 relaxation times were significantly elevated for the ACLR + LET group in LFC-1 (51.2 ± 0.7 ms vs 49.1 ± 0.7 ms, respectively; P = .03) and LFC-4 (45.9 ± 0.5 ms vs 44.2 ± 0.6 ms, respectively; P = .04) compared with the ACLR alone group. All effect sizes were small to medium. There was no difference in Anterior Cruciate Ligament OsteoArthritis Scores between groups (P = .99). Weak negative associations (rs = –0.27 to –0.22; P < .05) were found between relaxation times and quadriceps and hamstring strength in the anterolateral knee, while all other correlations were nonsignificant (P > .05). Conclusion: Increased relaxation times demonstrating small to medium effect sizes suggested early biochemical changes in articular cartilage of the anterolateral compartment in the ACLR + LET group compared with the ACLR alone group. Further evidence and long-term follow-up are needed to better understand the association between these results and the potential risk of the development of osteoarthritis in our patient cohort.

Limb schwannoma: Factors for postoperative neurologic deficit and poor functional results

IntroductionNeurologic complications after limb schwannoma resection are not unusual, but there is no consensus on risk factors for neurologic deficit or poor functional results. We therefore conducted a retrospective study, to screen for factors predicting, firstly, postoperative neurologic deficit and, secondly, poor functional results. HypothesisCertain pre- and intraoperative features predict risk of failure, poor results or aggravation. Patients and methodsA single-center retrospective study was conducted in the University Hospital of Lille, France, for the period January 2004 to March 2020, including 71 patients. Preoperative variables (gender, age, symptoms, progression, tumor location and size) and operative data (type of surgery) were collected as possible risk factors for postoperative sensory deficit (Weber) and/or motor deficit [Medical Research Council (MRC)] and poor functional result [Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH); Lower Extremity Functional Scale (LEFS) and douleur neuropathique (neuropathic pain) 4 (DN4)]. ResultsResults were assessed a mean 69.4±38.5 months’ follow-up (range, 6–180 months). In total, 21 patients (29.6%) had deficits (21 sensory, 1 motor) preoperatively and 25 patients (35.2%) postoperatively (20 sensory, 9 motor) (p=0.689). Fourteen patients (19.7%) showed functional aggravation. Fascicular resection was associated with risk of postoperative deficit [OR = 4.65 (95% CI: 1.485–15.543); p=0.004] and functional deterioration [OR = 3.9 (95% CI: 1.143–13.311); p=0.042]. Thirteen patients (18.3%) showed no improvement on DN4. Preoperative pain was a factor for improvement on DN4 [OR = 3.667 (95% CI: 1.055–12.738); p=0.0409]. DiscussionThe study identified fascicular resection as a risk factor for postoperative deficit and functional deterioration after limb schwannoma resection. Patients with preoperative neuropathic pain showed alleviation. Resection should be precise, under magnification, avoiding fascicular resection. Preoperative patient information is essential. Level of evidenceIV; retrospective series.

Proximal Hamstring Repair With All-Suture Anchors and an Accelerated Rehabilitation and Bracing Protocol Demonstrates Good Outcomes at 1-Year Follow-Up

To evaluate patient-reported outcomes and risk for rerupture after surgical treatment of proximal hamstring tendon ruptures using all-suture anchors and a unique postoperative bracing strategy. A retrospective review of a prospectively collected database was conducted of patients undergoing proximal hamstring repair or reconstruction from 2020 to 2022 at a tertiary, academic institution. Patients were included if they reached minimum 1-year follow-up and completed postoperative patient-reported outcomes. The surgical protocol for proximal hamstring repairs included all-suture anchors placed either in an open or endoscopic fashion in the ischial tuberosity. After surgery, all patients underwent an accelerated rehabilitation protocol, including 6 weeks touchdown weight-bearing in a hinged knee brace locked in extension for ambulation, allowing passive knee flexion to 90° while seated. Descriptive statistics were used to analyze the data. Twenty-one patients were included (mean age 50.4 ± 9.5 years, body mass index 24.4 ± 3.5, 66.7% female). Lower Extremity Functional Scale score achieved postoperatively was 74.2 ± 7.5 (out of 80). Patients had minimal pain (mean visual analog scale pain score of 0.9 ± 1.2). 61.9% of patients were able to return to the same level of activity after based on Tegner score by 1 year. Postoperative Single Assessment Numeric Evaluation activity of daily living was 94.3 ± 8.3, and Single Assessment Numeric Evaluation Sports was 82.3 ± 19.0. Mean Short Form Survey (SF-12) postoperative scores were 51.6 ± 6.8 for SF-12 Physical Component Score and 53.9 ± 9.7 for Mental Component Score. 95.2% (20 of 21) patients were satisfied with their outcome. There were no reruptures, infections, or reoperations. One patient of 21 (4.8%) incurred a postoperative deep venous thrombosis, which was treated with therapeutic anticoagulation for 3 months. All-suture anchors for proximal hamstring repair with a unique accelerated postoperative rehabilitation and bracing protocol result in good outcomes and patient satisfaction with minimal risk of complications. Level IV, case series, therapeutic.

Comparison of Outcomes at Midterm Follow-up of Operatively and Nonoperatively Treated Isolated Weber B Ankle Fractures.

A novel protocol was previously presented for nonoperative management of Weber B (OTA/AO 44B) ankle fractures with criteria of medial clear space <7 mm on gravity stress (GS) radiographs and ipsilateral superior clear space and contralateral GS medial clear space within 2 mm. This study recruited an operative cohort for comparison of outcomes. Retrospective cohort study. Level 1 academic center. The recruited operative cohort consisted of patients who may have been considered for the nonoperative protocol, but underwent surgery instead. Kellgren-Lawrence scale for evaluation of arthritis, American Orthopedic Foot and Ankle Society Hindfoot, Olerud Molander Ankle, Lower Extremity Functional Scale (LEFS), and PROMIS (physical function, depression, pain interference) scores for the current operative cohort were compared with that of the original nonoperative cohort. There were 20 patients in the operative cohort and 29 in the original nonoperative cohort. Mean follow-up was 6.9 and 6.7 years, respectively. The following outcome scores were better for the nonoperative cohort compared with the operative, respectively: LEFS, 75.2 and 68.1 ( P = 0.009); Olerud Molander Ankle, 94.1 and 89.0 ( P = 0.05); American Orthopedic Foot and Ankle Society, 98.5 and 91.7 ( P = 0.0003); PROMIS Physical Function, 58.2 and 50.4 ( P = 0.01); PROMIS Pain Interference, 42.2 and 49.7 ( P = 0.004). The PROMIS Depression, 42.8 and 45.4 ( P = 0.29), was not different between groups. All patients achieved union of their fracture. Surgical complications included implant removal (15%), SPN neurapraxia (5%), and delayed wound healing (5%). In carefully selected patients with isolated Weber B fractures, nonoperative management may be considered because it can lead to equivalent or superior outcomes with none of the risks typically associated with surgical intervention. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Comparison of fatigue and functional status in elderly type 2 diabetes patients versus age and gender matched individuals

AbstractIntroductionFatigue is a common yet not frequently explored complication of diabetes. There are fewer studies available on the impact of diabetes on the severity of fatigue and the functional status of patients.MethodsFifty individuals meeting the inclusion criteria were included. The individuals were divided into two groups: group A (diabetic elderly individuals) and group B (nondiabetic age and gender‐matched individuals). An observational analytical study was conducted. Outcome measures used were: fatigue severity scale (FSS), lower extremity functional scale (LEFS), 6‐minute walk distance (6MWD), and 30‐second chair stand test. SPSS 16 was used to analyze data.ResultsAs per the normality test, a between‐group comparison of fatigue severity scale (FSS) score, chair stand test score, and LEFS score was carried out by a nonparametric Mann–Whitney test, which showed a statistically significant difference between the groups (P &lt; 0.05). Between‐group comparison of 6MWD was carried out by parametric unpaired t test. The results showed a statistically significant difference in the distance walked by both groups.ConclusionHigher levels of fatigue and impaired functional status along with reduced strength and function of lower limbs was seen in elderly patients with type 2 diabetes Inclusion of symptom assessment and strategies to reduce the burden of fatigue in diabetes patient should be incorporated.

Efficacy of modified active physical therapy program on pain, muscle strength, and function in adolescent football players with osteitis pubis

BackgroundIn athletes, osteitis pubis (OP) is considered a major cause of chronic groin pain. In addition to the difficulties with diagnosis, controversy exists regarding the most appropriate treatment approach. The study aimed to evaluate the effect of a modified active physical therapy program (MAPT) on pain, hip and trunk muscle strengths, and lower extremity function in adolescent football players with OP.MethodsFifty football players aged from 12 to 18 years with OP were included and allocated into two groups: the MAPT group (n = 24) and the traditional physical therapy (TPT) group (n = 26). Each group received a different treatment protocol for 60 min applied 3 times/week for 12 weeks. A visual analog scale, digital hand-held dynamometer (HHD), and lower extremity functional scale (LEFS) were used to measure pain, hip and trunk muscle strengths, and lower limb function, respectively, at baseline and 12 weeks post-intervention.ResultsThere was a highly significant difference in the TPT group’s pain score (p < 0.001) compared with the MAPT group. Also, the strength of hip flexors, abductors, adductors, internal rotators, external rotators, and trunk flexors and extensors improved significantly (p < 0.05) than the TPT group. However, the between-group analysis revealed that the strength of hip extensors and LEFS in the MAPT group achieved a highly significant difference (p < 0.001) compared with the TPT group.ConclusionMAPT could be recommended strongly in the rehabilitation of OP in adolescent football players in which the functional abilities of OP patients improved because of reduced pain levels and increased hip and trunk muscle strength. (IRCT20210909052421N3, Iranian Registry of Clinical Trials, https://www.irct.ir/trial/68946/pdf, 9-April-2023).

Comparison of post isometric relaxation and post facilitation stretching techniques on hamstring muscle flexibility in collegiate athletes: A randomized clinical trial

Background: The multi-jointed nature of the hamstring muscles causes them to shorten which impacts the biomechanics of the pelvis and lumber region. Hamstring tightness is more common in women than in males. Objective: To compare the effect of post-isometric relaxation and post-facilitation stretching in improving hamstring muscle flexibility among collegiate athlete's athlete. Methods: Study was a randomized clinical trial. Patients following the inclusion criteria from Pakistan Sports Board, Lahore were categorized in two groups; group A and group B. Male patients aged from 18 to 35 years, with a history of hamstring muscle tightness (bilateral) or acute hamstring injuries were included. Group A was treated with post isometric relaxation and conventional treatment while group B received post facilitation stretching and conventional treatment; for 4 weeks and with 3 sessions per week. The baselines data was taken for range of motion, sit and reach test, active knee extension test, and straight leg raise and lower extremity functional scale. Results: There were a total of 17 male volunteers in each group. Group A's mean age was 28.58±3.9, years whereas group B's mean age was 29.25±4.4 The groups' respective Lower Limb Functional Scores (LEFS) were 58.41±4.84 in group A and 40.52±2.85 in group B, with a p-value of less than 0.05. Lower limb functional score (LEFS) within the groups with p &lt;0.05 was 22.17±8.63 and 40.52±2.85. Conclusion: The current investigation found that post-isometric relaxing and stretching both improve hamstring flexibility. Clinical Trial Number: NCT05727501

Prevalence and levels of disability post road traffic orthopaedic injuries in Rwanda.

Prolonged disability resulting from road traffic injuries (RTIs) contributes significantly to morbidity and disease burden. A good understanding of the prevalence and the level of disability of orthopaedic injuries in developing countries is crucial for improvement; however, such data are currently lacking in Rwanda. To determine the prevalence and levels of disability of 2 years post-road traffic orthopaedic injuries in Rwanda. A multicentre, cross-sectional study from five Rwandan referral hospitals of 368 adult RTI victims' sustained from accidents in 2019. Between 02 June 2022, and 31 August 2022, two years after the injury, participants completed the World Health Organization Disability Assessment Schedule (WHODAS 2.0) Questionnaire for the degree of impairment and the Upper Extremity Functional Scale and Lower-Extremity Functional Scale forms for limb functional evaluation. Descriptive, inferential statistics Chi-square and multinomial regression models were analysed using R Studio. The study's mean age of the RTOI victims was 37.5 (±11.26) years, with a sex ratio M: F:3: 1. The prevalence of disability following road traffic orthopedic injury (RTOI) after 2 years was 36.14%, with victims having WHODAS score > 25.0% and 36.31% were still unable to return to their usual activities. Age group, Severe Kampala Trauma Score and lack of rehabilitation contributed to disability. The most affected WHODAS domains were participation in society (33%) and life activities (28%). The prevalence and levels of disability because of RTOI in Rwanda are high, with mobility and participation in life being more affected than other WHODAS domains. Middle-aged and socio-economically underprivileged persons are the most affected. This study showed that a good rehabilitation approach and economic support for the RTI victims would decrease their disabilities in Rwanda.

Effect of Body Mass Index and Ankle Dorsiflexion in Planter Fasciitis Patients; Performance Perspective

Objective: To determine the effects of body mass index and ankle dorsiflexion in patients with plantar fasciitis.Study Design: A cross-sectional.Place and Duration of Study: The study was carried out at the Department of Physical Therapy of the two leading tertiary care centers, Advance Orthopedic &amp; Reconstructive Institute &amp; Dr. Ziauddin Hospital Karachi, Pakistan from August 2022 to June 2023.Methods: Sixty-Four participants were recruited from the physical therapy departments of two tertiary care centers in Karachi by convenience sampling. The study focuses on the impact of demographics on the performance of plantar fasciitis patients. The measurement tools used in this are BMI (Body mass index), NRS (Numeric rating scale), LEFS (Lower extremity functional scale), and Goniometer. The data were analyzed by SPSS version 23.0. Results: Our findings show that plantar fasciitis is more common in the obese-II category with reference to BMI, females are more affected than males with reference to gender, the middle age group is more affected with reference to age and dorsiflexion angle of patients is less than normal range shows the directly proportional of demographics with the performance of patients with plantar fasciitis.Conclusion: Our study showed the positive effect of ankle dorsiflexion angle and BMI, gender, pain, and age on the physical performance of plantar fasciitis patients.&#x0D; How to cite this: Lata P, Hayat S, Kumar V, Hassan MF, Batool S, Sandeela KA, Jamil K. Effect of Body Mass Index and Ankle Dorsiflexion in Planter Fascitis Patients; Performance Perspective. Life and Science. 2024; 5(1): 113-119. doi: http://doi.org/10.37185/LnS.1.1.461

Functional and Psychological Preparedness of Athletes Post ACL Repair.

This study was conducted to see whether those who had anterior cruciate ligament (ACL) reconstructions on their dominant legs performed better than those who had them on their nondominant legs 1-10 years after the surgery. An examination of people who sustained injuries to their dominant (n = 25) and nondominant (n = 25) legs between 1 and 10 years after ACL repair was undertaken in a cross-sectional research with 50 people aged 20-38. Everyone takes the fear avoidance belief questionnaire for physical activity (FABQ-PA), the lower extremity functional scale (LEFS), and the anterior cruciate ligament return to sport after injury (ACL-RSI) survey. There was no statistically significant difference between the groups on the ACL-RSI, LEFS, and FABQ-PA (U = 254, P = 0.26; U = 314.4, P = 0.95; and U = 279.4, P = 0.53 correspondingly). Functional performance and patient mental health should be evaluated 1-10 years after ACL surgery. However, there is no correlation between which leg was the dominant one and the results. As a result, it has been shown that both dominant and nondominant leg injuries heal similarly over time. Future studies should examine additional variables that affect healing and return-to-sport results to improve rehabilitation and optimize long-term functional outcomes for individuals after ACL repair.