scholarly journals Determinants of Function After Total Knee Arthroplasty

2003 ◽  
Vol 83 (8) ◽  
pp. 696-706 ◽  
Author(s):  
C Allyson Jones ◽  
Donald C Voaklander ◽  
Maria E Suarez-Almazor
Keyword(s):  
Functional Status ◽  
Physical Function ◽  
Short Form ◽  
Study Data ◽  
Walking Distance ◽  
Comorbid Conditions ◽  
Function Score ◽  
Sf 36 ◽  
Physical Function Score ◽  
Total Knee

Abstract Background and Purpose. Decreasing hospital stays for patients with total knee arthroplasties (TKAs) have a direct effect on rehabilitation. The identification of modifiable determinants of postsurgical functional status would help physical therapists plan for discharge from hospitals. The purpose of this study was to identify preoperative determinants of functional status after a TKA. Participants. Using a community-based, prospective cohort study, data were collected from 276 patients who received a primary TKA in a Canadian health care region. Data were collected in the month before surgery and 6 months after surgery. Methods. Function was measured using the function subscale of a disease-specific measure—the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index—and a generic health status measure—the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Independent variables examined included demographic variables (eg, age, sex), medical variables (eg, diagnosis, number of comorbid conditions, ambulatory status), surgical variables (eg, type of implant, number of complications), and knee range of motion. Results. At 6 months after surgery, the average WOMAC physical function score was 70.5 (SD=18.2) and the average SF-36 physical function score was 44.8 (SD=25.3). Using multiple regression analyses, baseline function, walking device, walking distance, and comorbid conditions predicted 6-month function (WOMAC: R2=.20; SF-36 physical function: R2=.27). Discussion and Conclusion. Patients who have lower preoperative function may require more intensive physical therapy intervention because they are less likely to achieve functional outcomes similar to those of patients who have less preoperative dysfunction.

scholarly journals How to predict return to work after lumbar discectomy: answers from the NeuroPoint-SD registry

2016 ◽  
Vol 25 (2) ◽  
pp. 181-186 ◽  
Author(s):  
Khoi D. Than ◽  
Jill N. Curran ◽  
Daniel K. Resnick ◽  
Christopher I. Shaffrey ◽  
Zoher Ghogawala ◽  
...  
Keyword(s):  
Return To Work ◽  
Physical Function ◽  
Smoking Status ◽  
Lumbar Discectomy ◽  
Work Status ◽  
Function Score ◽  
Younger Age ◽  
Sf 36 ◽  
Physical Function Score ◽  
Working Status

OBJECTIVE To date, the factors that predict whether a patient returns to work after lumbar discectomy are poorly understood. Information on postoperative work status is important in analyzing the cost-effectiveness of the procedure. METHODS An observational prospective cohort study was completed at 13 academic and community sites (NeuroPoint–Spinal Disorders [NeuroPoint-SD] registry). Patients undergoing single-level lumbar discectomy were included. Variables assessed included age, sex, body mass index (BMI), SF-36 physical function score, Oswestry Disability Index (ODI) score, presence of diabetes, smoking status, systemic illness, workers' compensation status, and preoperative work status. The primary outcome was working status within 3 months after surgery. Stepwise logistic regression analysis was performed to determine which factors were predictive of return to work at 3 months following discectomy. RESULTS There were 127 patients (of 148 total) with data collected 3 months postoperatively. The patients' average age at the time of surgery was 46 ± 1 years, and 66.9% of patients were working 3 months postoperatively. Statistical analyses demonstrated that the patients more likely to return to work were those of younger age (44.5 years vs 50.5 years, p = 0.008), males (55.3% vs 28.6%, p = 0.005), those with higher preoperative SF-36 physical function scores (44.0 vs 30.3, p = 0.002), those with lower preoperative ODI scores (43.8 vs 52.6, p = 0.01), nonsmokers (83.5% vs 66.7%, p = 0.03), and those who were working preoperatively (91.8% vs 26.2%, p < 0.0001). When controlling for patients who were working preoperatively (105 patients), only age was a statistically significant predictor of postoperative return to work (44.1 years vs 51.1 years, p = 0.049). CONCLUSIONS In this cohort of lumbar discectomy patients, preoperative working status was the strongest predictor of postoperative working status 3 months after surgery. Younger age was also a predictor. Factors not influencing return to work in the logistic regression analysis included sex, BMI, SF-36 physical function score, ODI score, presence of diabetes, smoking status, and systemic illness. Clinical trial registration no.: 01220921 (clinicaltrials.gov)

scholarly journals Improvement in Health-related Quality of Life After Total Ankle Arthroplasty Compares Well to Other Successful Orthopaedic and Non-orthopaedic Procedures

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0007
Author(s):  
James Lachman ◽  
Samuel Adams ◽  
James DeOrio ◽  
Mark Easley
Keyword(s):  
Physical Function ◽  
Health Related Quality ◽  
Ankle Arthritis ◽  
Function Score ◽  
Sf 36 ◽  
Physical Function Score ◽  
Related Quality ◽  
Health Related ◽  
End Stage

Category: Ankle Arthritis Introduction/Purpose: End-Stage arthritis is one of the leading causes of chronic disability in the United States. Improvement in Health-Related Quality of Life(HRQOL) after total ankle arthroplasty(TAA) has been demonstrated in the literature. This improvement has not been compared to that of other common Orthopaedic and non-Orthopaedic procedures including Anterior Cervical Discectomy and Fusion(ACDF), Total Knee Arthroplasty(TKA), Coronary Artery Bypass Grafting(CABG), and Orthotopic Liver Transplant(OLT). Although TAA is noted to be effective in eliminating symptoms in end-stage arthritis, it is difficult to gauge the impact of TAA relative to other meaningful procedures that have been shown to have great impact on HRQOL improvement. The purpose of this study was to compare changes in HRQOL between TAA and other common procedures with large impacts on this outcomes measure. Methods: Five hundred consecutive patients with minimum of two-years follow-up after TAA were prospectively evaluated with the Short Form-36(SF-36) outcome instrument preoperatively, at six months, one year and two years post-operatively. An exhaustive literature review was conducted identifying studies with comparatively sample sizes comparing preoperative and postoperative SF-36 scores after ACDF, TKA, CABG, and OLT. The SF-36 Physical and Mental component scores were included in each cohort and compared for magnitude of improvement and significant differences between them. Results: Patients in all cohorts had preoperative SF-36 mental and physical function scores significantly lower than the general population scores. The preoperative physical function scores were lowest in the TKA group (average 31.1 +/-9.7) followed by TAA group (average 40.6 +/-16.3), ACDF group (average 41.5 +/-21.6), OLT group (average 51.9 +/-23.6) and CABG groups (57.8 +/-21.3), respectively. Improvement after surgery was greatest in the ACDF group (Mental +31.5, Physical +22.9), followed by the TAA group (Mental +13.9, Physical +26.8), TKA group (Mental +14.3, Physical +22.4), CABG group (Mental +7.6, Physical +15.4) and OLT group (Mental -4.47, Physical +9.8), respectively. The greatest improvement in physical function score occurred in the TAA group (see attached table). Conclusion: The mental and physical disability associated with end-stage ankle arthritis is as severe as that associated with many other Orthopaedic and non-Orthopaedic conditions. The improvement in HRQOL after TAA is greater than that obtained after TKA, CABG, and OLT but not as great as the improvement seen after ACDF; however, the improvement in physical function score was greatest in the TAA cohort. The HRQOL benefits of TAA are comparable to the benefits achieved after several other relatively common and successful surgical procedures.

scholarly journals Predictors of Hand Contracture in Early Systemic Sclerosis and the Effect on Function: A Prospective Study of the GENISOS Cohort

2019 ◽  
Vol 46 (12) ◽  
pp. 1597-1604 ◽  
Author(s):  
Maryam Buni ◽  
Joyce Joseph ◽  
Claudia Pedroza ◽  
Sam Theodore ◽  
Deepthi Nair ◽  
...  
Keyword(s):  
Functional Status ◽  
Short Form ◽  
Health Assessment ◽  
Diffuse Disease ◽  
Sf 36 ◽  
Physical Function Score ◽  
The Difference ◽  
Rate Of Decline ◽  
A Prospective Study ◽  
Over Time

Objective.To identify baseline features that predict progression of hand contractures and to assess the effect of contractures on functional status in the prospective GENISOS cohort.Methods.Rate of decline in hand extension, as an indicator of hand contracture, was the primary outcome. We assessed longitudinal hand extension measurements, modified Health Assessment Questionnaire (MHAQ) score, Medical Outcomes Study Short Form-36 (SF-36) physical function score, and demographic, clinical, and serological variables. Subjects with ≥ 2 hand measurements at least 6 months apart were included.Results.A total of 1087 hand measurements for 219 patients were available over an average of 8.1 ± 4.8 years. Hand extension decreased on average by 0.11 cm/year. Antitopoisomerase I antibody (ATA) positivity and higher modified Rodnan Skin Score (mRSS) were predictive of faster decline in hand extension (p = 0.009 and p = 0.046, respectively). In a subgroup analysis of 62 patients with ≤ 2 years from SSc onset, ATA and diffuse disease type were associated with faster decline in hand extension; anticentromere positivity was associated with slower rate of decline. Although the rate of decline in patients with disease duration ≤ 2 years was numerically higher, the difference was not statistically significant. Hand extension continued to decline in a linear fashion over time and was inversely related to overall functional status.Conclusion.ATA was predictive of contracture development in both early disease (≤ 2 yrs) and in the overall cohort. Hand extension declined linearly over time and was inversely associated with MHAQ and SF-36 scores. ATA positivity and higher baseline mRSS were predictive of faster decline in hand extension.

Auricular vagal nerve stimulation in peripheral arterial disease patients

VASA ◽  
2017 ◽  
Vol 46 (6) ◽  
pp. 462-470 ◽  
Author(s):  
Gerald Hackl ◽  
Andreas Prenner ◽  
Philipp Jud ◽  
Franz Hafner ◽  
Peter Rief ◽  
...  
Keyword(s):  
Primary Endpoint ◽  
Nerve Stimulation ◽  
Short Form ◽  
Therapeutic Option ◽  
Arterial Disease ◽  
Walking Distance ◽  
Control Group ◽  
Sf 36 ◽  
Peripheral Arterial ◽  
Double Blinded

Abstract. Background: Auricular nerve stimulation has been proven effective in different diseases. We investigated if a conservative therapeutic alternative for claudication in peripheral arterial occlusive disease (PAD) via electroacupuncture of the outer ear can be established. Patients and methods: In this prospective, double-blinded trial an ear acupuncture using an electroacupuncture device was carried out in 40 PAD patients in Fontaine stage IIb. Twenty patients were randomized to the verum group using a fully functional electroacupuncture device, the other 20 patients received a sham device (control group). Per patient, eight cycles (1 cycle = 1 week) of electroacupuncture were performed. The primary endpoint was defined as a significantly more frequent doubling of the absolute walking distance after eight cycles in the verum group compared to controls in a standardized treadmill testing. Secondary endpoints were a significant improvement of the total score of the Walking Impairment Questionnaire (WIQ) as well as improvements in health related quality of life using the Short Form 36 Health Survey (SF-36). Results: There were no differences in baseline characteristics between the two groups. The initial walking distance significantly increased in both groups (verum group [means]: 182 [95 % CI 128–236] meters to 345 [95 % CI 227–463] meters [+ 90 %], p < 0.01; control group [means]: 159 [95 % CI 109–210] meters to 268 [95 % CI 182–366] meters [+ 69 %], p = 0.01). Twelve patients (60 %) in the verum group and five patients (25 %) in controls reached the primary endpoint of doubling walking distance (p = 0.05). The total score of WIQ significantly improved in the verum group (+ 22 %, p = 0.01) but not in controls (+ 8 %, p = 0.56). SF-36 showed significantly improvements in six out of eight categories in the verum group and only in one of eight in controls. Conclusions: Electroacupuncture of the outer ear seems to be an easy-to-use therapeutic option in an age of increasingly invasive and mechanically complex treatments for PAD patients.

scholarly journals NONOPERATIVE VERSUS OPERATIVE TREATMENT OF PATIENTS WITH DEGENERATIVE SPONDYLOLISTHESIS

2016 ◽  
Vol 15 (1) ◽  
pp. 33-35
Author(s):  
Jose Alfredo Corredor ◽  
Fernando Flores de Araújo ◽  
Rodrigo Góes de Mendonça ◽  
Noel Oizerovici Foni ◽  
Nelson Astur ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Short Form ◽  
Degenerative Spondylolisthesis ◽  
Functional Results ◽  
Good Health ◽  
Nonoperative Treatment ◽  
Function Score ◽  
Cross Sectional ◽  
Sf 36 ◽  
Functional Scores

ABSTRACT Objective: To evaluate clinical and functional results of patients with lumbar degenerative spondylolisthesis treated with operatively or nonoperatively. Methods: Patients with degenerative spondylolisthesis treated either nonoperatively or operatively from 2004 to 2014 were selected from databases and a cross-sectional evaluation was performed. Outcome measures included back and leg visual analogue scales (VAS), Fischgrund criteria, Short Form-36 (SF-36) function score, and the modified Oswestry Disability Index (ODI). Results: 43 patients were evaluated: 20 with nonoperative treatment and 23 with operative treatment. Baseline characteristics were similar without significant differences between groups. Mean follow-up time was 43 months (range 10 - 72) for the nonoperative group and 36 months (range 6-80) for the operative group. Significant statistical difference in favor of operative group were found in back VAS (mean 4 versus 8, p = 0.000), leg VAS (mean 3 versus 6, p = 0.0015), SF-36 function score (mean 77 versus 35, p = 0.000), and ODI (mean 17 versus 46, p = 0.000). On the basis of the Fischgrund criteria, only 10 % of patients reported excellent or good health post nonoperative treatment versus 83% for those treated operatively (p = 0.000). Conclusion: In this cross-sectional study, we observed that symptomatic patients with degenerative spondylolisthesis who underwent operative treatment have superior clinical and functional scores compared to those that underwent nonoperative treatment.

scholarly journals The association between pain catastrophizing, physical function and pain in a cohort of patients undergoing knee arthroplasty

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Sara Birch ◽  
Maiken Stilling ◽  
Inger Mechlenburg ◽  
Torben Bæk Hansen
Keyword(s):  
Physical Function ◽  
Knee Arthroplasty ◽  
General Health ◽  
Pain Catastrophizing ◽  
Short Form ◽  
Oxford Knee Score ◽  
Preoperative Pain ◽  
Sf 36 ◽  
Before And After ◽  
One Year

Abstract Background Pain catastrophizing contributes to acute and long-term pain after knee arthroplasty (KA), but the association between pain catastrophizing and physical function is not clear. We examined the association between preoperative pain catastrophizing and physical function one year after surgery, as well as differences in physical function, pain and general health in two groups of patients with high and low preoperative pain catastrophizing score. Methods We included 615 patients scheduled for KA between March 2011 and December 2013. Patients completed The Pain Catastrophizing Scale (PCS) prior to surgery. The Oxford Knee Score (OKS), Short Form-36 (SF-36) and the EuroQol-5D (EQ-5D) were completed prior to surgery, and 4 and 12 months after the surgery. Results Of the 615 patients, 442 underwent total knee arthroplasty (TKA) and 173 unicompartmental knee arthroplasty (UKA). Mean age was 67.3 (SD: 9.7) and 53.2% were females. Patients with PCS > 21 had statistically significantly larger improvement in mean OKS for both TKA and UKA than patients with PCS < 11; 3.2 (95% CI: 1.0, 5.4) and 5.4 (95% CI: 2.2, 8.6), respectively. Furthermore, patients with preoperative PCS > 21 had statistically significantly lower OKS, SF-36 and EQ-5D and higher pain score than patients with PCS < 11 both preoperatively and 4 and 12 months postoperatively. Conclusions Patients with high levels of preoperative pain catastrophizing have lower physical function, more pain and poorer general health both before and after KA than patients without elevated pain catastrophizing.

PROMIS Physical Function Score Strongly Correlates With Legacy Outcome Measures in Minimally Invasive Lumbar Microdiscectomy

Spine ◽  
2019 ◽  
Vol 44 (6) ◽  
pp. 442-446 ◽  
Author(s):  
Benjamin Khechen ◽  
Brittany E. Haws ◽  
Dil V. Patel ◽  
Mundeep S. Bawa ◽  
Islam M. Elboghdady ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Physical Function ◽  
Outcome Measures ◽  
Function Score ◽  
Lumbar Microdiscectomy ◽  
Physical Function Score

scholarly journals An Eccentrically Biased Rehabilitation Program Early after TKA Surgery

Arthritis ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Robin L. Marcus ◽  
Yuri Yoshida ◽  
Whitney Meier ◽  
Christopher Peters ◽  
Paul C. LaStayo
Keyword(s):  
Physical Function ◽  
Muscle Function ◽  
Knee Extension ◽  
Rehabilitation Program ◽  
Walk Test ◽  
Six Minute Walk Test ◽  
Sf 36 ◽  
Total Knee ◽  
Minute Walk

Rehabilitation services are less-studied aspects of the management following total knee arthroplasty (TKA) despite long-term suboptimal physical functioning and chronic deficits in muscle function. This paper describes the preliminary findings of a six-week (12 session) eccentrically-biased rehabilitation program targeted at deficits in physical function and muscle function, initiated one month following surgery. A quasiexperimental, one group, pretest-posttest study with thirteen individuals (6 female, 7 male; mean age years) examined the effectiveness of an eccentrically-biased rehabilitation program. The program resulted in improvements in the primary physical function endpoints (SF-36 physical component summary and the six-minute walk test) with increases of 59% and 47%, respectively. Muscle function endpoints (knee extension strength and power) also increased 107% and 93%, respectively. Eccentrically-biased exercise used as an addition to rehabilitation may help amplify and accelerate physical function following TKA surgery.

scholarly journals Quality of Life After Pulmonary Rehabilitation: Assessing Change Using Quantitative and Qualitative Methods

2000 ◽  
Vol 80 (10) ◽  
pp. 986-995 ◽  
Author(s):  
Pat G Camp ◽  
Jessica Appleton ◽  
W Darlene Reid
Keyword(s):  
Quality Of Life ◽  
Qualitative Research ◽  
Qualitative Methods ◽  
Physical Function ◽  
Pulmonary Rehabilitation ◽  
Short Form ◽  
Well Being ◽  
Sf 36 ◽  
Quantitative And Qualitative Methods

Abstract Background and Purpose. The purpose of this study was to use quantitative and qualitative research methods to evaluate quality-of-life (QOL) changes in patients with chronic obstructive pulmonary disease (COPD) after pulmonary rehabilitation. Subjects. Twenty-nine individuals with COPD (18 women and 11 men), with a mean age of 69 years (SD=8.6, range=53–92), participated. Methods. Subjects were assessed before and after a 5-week control phase and after a 5-week rehabilitation phase using the Chronic Respiratory Questionnaire (CRQ), the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and spirometry. Our qualitative research was based on a subsample of 7 subjects who were interviewed after pulmonary rehabilitation. Results. Pulmonary rehabilitation improved QOL, as demonstrated by increases of 22% and 14% in the physical function categories of the CRQ and the SF-36, respectively, and by an increase of 10% in the CRQ's emotional function category. The qualitative data indicated how pulmonary rehabilitation influenced QOL. Conclusion and Discussion. The use of both quantitative and qualitative methods illustrated the nature of improvement in QOL after pulmonary rehabilitation. Improved physical function, less dyspnea, and a heightened sense of control over the subjects' COPD resulted in increased confidence and improved emotional well-being.

Sign in / Sign up

Export Citation Format

Share Document