geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Can an integrated orthotic and rehabilitation program decrease pain and improve function after lower extremity trauma?


, : Can an integrated orthotic and rehabilitation program decrease pain and improve function after lower extremity trauma?. Clinical Orthopaedics and Related Research 472(10): 3017-3025

Patients with severe lower extremity trauma have significant disability 2 years after injury that worsens by 7 years. Up to 15% seek late amputation. Recently, an energy-storing orthosis demonstrated improved function compared with standard orthoses; however, the effect when integrated with rehabilitation over time is unknown. (1) Does an 8-week integrated orthotic and rehabilitation initiative improve physical performance, pain, and outcomes in patients with lower extremity functional deficits or pain? (2) Is the magnitude of recovery different if enrolled more than 2 years after their injury versus earlier? (3) Does participation decrease the number considering late amputation? We prospectively evaluated 84 service members (53 less than and 31 > 2 years after injury) who enrolled in the initiative. Fifty-eight sustained fractures, 53 sustained nerve injuries with weakness, and six had arthritis (there was some overlap in the patients with fractures and nerve injuries, which resulted in a total of > 84). They completed 4 weeks of physical therapy without the orthosis followed by 4 weeks with it. Testing was conducted at Weeks 0, 4, and 8. Validated physical performance tests and patient-reported outcome surveys were used as well as questions pertaining to whether patients were considering an amputation. By 8 weeks, patients improved in all physical performance measures and all relevant patient-reported outcomes. Patients less than and greater than 2 years after injury improved similarly. Forty-one of 50 patients initially considering amputation favored limb salvage at the end of 8 weeks. We found this integrated orthotic and rehabilitation initiative improved physical performance, pain, and patient-reported outcomes in patients with severe, traumatic lower extremity deficits and that these improvements were sustained for > 2 years after injury. Efforts are underway to determine whether the Return to Run clinical pathway with the Intrepid Dynamic Exoskeletal Orthosis (IDEO) can be successfully implemented at additional military centers in patients > 2 years from injury while sustaining similar improvements in patient outcomes. The ability to translate this integrated orthotic and rehabilitation program into the civilian setting is unknown and warrants further investigation.

US$19.90

PMID: 24744130

DOI: 10.1007/s11999-014-3609-7


Other references

Araujo, S.; Pompolo, S.; Perfectti, F.; Camacho, J., 2001: Integration of a B chromosome into the A genome of a wasp. B chromosomes are genome symbionts, the presence of which in many eukaryote species is explained, in most cases, by their violation of Mendelian rules, usually based on meiotic or mitotic instability, leading to their accumulation in the germ line...

Benmeir, P.; Rosenberg, L.; Sagi, A.; Vardi, D.; Eldad, A., 1990: Jellyfish envenomation: a summer epidemic. During the summer of 1987 the shores of Israel were infested by waves of jellyfish. Thirty patients, mainly children, suffering various degrees of painful injuries to different parts of their bodies were treated in our emergency ward. A typical ca...

Guerin Hubert, 1973: Distribution of manganese in some continental and oceanic volcanic series. Reunion Annuelle des Sciences de la Terre Pages 216

Mock R., 1973: Piglet health and gut epithelium. Journal Of Animal Science: 207

Blume, E., 1987: Poisoned peaches, toxic tomatoes: reckoning pesticide risks. A brief commentary citing a much-publicized 1987 report of the US National Academy of Sciences and studies performed by the independent Natural Resources Defense Council (NRDC) discusses the potential carcinogenic risks caused by pesticide residue...

Doze, V.A., 2001: Catecholaminergic disinhibition in the rat hippocampus. The catecholamines, norepineprhine and epinephrine, produce disinhibition in the CA1 region of the hippocampus as evidenced by the appearance of multiple population spikes in field potentials recorded in response to a single electrical stimulus of...

Srivastava, R.K.; Ayachi, A.K.; Vandana Sehgal; Anoop Sen, 2001: Studies on the nitrate removal by water Hyacinth and Ipomea leaves. The paper deals with the use of two Indian plants species, i.e. water hyacinth and Ipomoea leaves, for the removal of nitrate from aqueous solutions. Various parameters like contact time, temperature, pH, adsorbent dose and stirring time were take...

Carreira, Jão.; Caseiro, R.; Batista, J.; Sminchisescu, C., 2015: Free-Form Region Description with Second-Order Pooling. Semantic segmentation and object detection are nowadays dominated by methods operating on regions obtained as a result of a bottom-up grouping process (segmentation) but use feature extractors developed for recognition on fixed-form (e.g. rectangu...

Jack, R.W., 1933: Notes on the Biology and Control of the Red Locust in Southern Rhodesia, 1932-33. Part I. Control of Locusts. In this paper, the usual mechanical and chemical methods of controlling locust hoppers are discussed. Spraying with sodium arsenite at the rate of 31/2 oz. (containing 80 per cent. arsenious oxide) to 4 gals. water is the standard method employed...

Schrader, S.M.; Rachlin, H., 1976: Variable interval and fixed interval schedule preferences in pigeons as a function of signaled reinforcement and schedule length. Pigeons were reinforced for pecking on 2 concurrent chain schedules. The terminal links consisted of a variable-interval or an arithmetically equivalent fixed-interval schedule. For half the subjects a brief response-independent change in key colo...