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 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 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.

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 Patient Outcomes Differences Following Ankle Fracture Fixation with or without Ankle Arthroscopy

2020 ◽  
Vol 5 (2) ◽  
pp. 2473011420S0001
Author(s):  
Kenneth S. Smith ◽  
Katherine D. Drexelius ◽  
Shanthan C. Challa ◽  
Daniel K. Moon ◽  
Joshua A. Metzl ◽  
...  
Keyword(s):  
Physical Function ◽  
Ankle Fracture ◽  
Patient Reported Outcomes ◽  
Chart Review ◽  
Ankle Arthroscopy ◽  
P Value ◽  
Function Score ◽  
Patient Reported ◽  
Physical Function Score

Category: Arthroscopy; Ankle; Trauma Introduction/Purpose: Ankle fractures are one of the most common types of fractures, yet there is currently no consensus about how best to treat these patients. The treatment approach typically includes open reduction-internal fixation (ORIF), but not all patients have a good clinical outcome. Intra-articular injuries have been suggested as one potential cause of these sub-optimal outcomes. Use of arthroscopy at the time of surgery is useful in identifying intra-articular lesions in acute ankle fractures, however, there is no evidence that arthroscopic intervention changes the patient’s outcome. Ankle arthroscopy increases the duration and potential complications of anesthesia administration and also increases cost. Our study assesses the clinical impact of arthroscopy accompanying an ankle fracture ORIF, which is essential to promote positive outcomes, while decreasing unnecessary complications and costs. Methods: This is a retrospective chart review. We queried all patients that underwent operative fixation of a bimalleolar or trimalleolar ankle fracture at our institution from January 1, 2014 through November 1, 2018. From this list, we excluded patients less than 18 years old and patients that had concomitant injuries to other body parts that required surgery. In addition, we only included Weber B and Weber C fibula fracture to homogenize the data. We then performed a chart review to extract all demographic data, fracture pattern, surgical procedures performed, tourniquet times, any revision surgeries, arthroscopic findings and any interventions performed due to the arthroscopic portion of the procedure. We then conducted a phone and email survey utilizing the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Short Form and the two question Patient Acceptable Symptom State (PASS). Results: Our study included 213 total patients (142 traditional ORIF, 71 ORIF plus arthroscopy) with an average age of 40 (standard deviation 14.2). The average follow up was 32.4 (13.1) months with a survey follow up rate of 50.7%. The demographic information between the two cohorts was statistically similar. The average tourniquet time for the arthroscopy cohort is 10 minutes longer (89 minutes versus 79 minutes). During the arthroscopy, there was a 28.2% rate of full thickness osteochondral lesions, 33.8% rate of loose bodies, and a 49.2% rate of small cartilage injury not requiring intervention. The mean PROMIS physical function score amongst Weber B fibula fractures was 45.8 and 42.3 in the arthroscopy and non-arthroscopy groups respectively (P value 0.012). In addition, the patient satisfaction rate in Weber B fibula fractures was higher in those patients that underwent arthroscopy as compared to ORIF alone (93.1% versus 75.5%, P value of 0.05). Patients that suffered a tibiotalar joint dislocation at the time of the ankle fracture had a significantly higher PROMIS physical function score (46.6 versus 40.2, P value 0.005) when their surgery included arthroscopy. Conclusion: Ankle arthroscopy at the time of ORIF led to higher mean patient reported outcomes for every tested metric but this reached statistical significance only when looking at the Weber B fibula fractures and ankle dislocations. There was no increase in complication rate and the arthroscopy took only 10 minutes longer on average. [Table: see text]

Physical and mental functioning in colorectal cancer (CRC) survivors by work status.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 126-126 ◽  
Author(s):  
Crystal Shereen Denlinger ◽  
Sarah Hegarty ◽  
Pamela Joyce Shapiro ◽  
Carolyn Y Fang ◽  
Andrea Marie Barsevick
Keyword(s):  
Return To Work ◽  
Mail Survey ◽  
Work Status ◽  
Intensive Management ◽  
Mental Functioning ◽  
Curative Therapy ◽  
Department Of Health ◽  
Younger Age ◽  
Returning To Work ◽  
Component Scores

126 Background: Comorbidities and treatment-related symptoms (sx) affect overall function and may impact return to work. We evaluated SF-12 physical and mental functioning in CRC working (W) and non-working (NW) survivors. Methods: 300 Stage I-III CRC survivors age 25-70 years identified by PA Cancer Registry who completed curative therapy 3-5 years prior to study and were employed at diagnosis were surveyed with validated measures via mail-survey procedures. Current work status (working/not working), demographics, and medical factors (diagnosis, treatment, comorbidities) were assessed, as was fatigue, insomnia, distress, cognitive sx, neuropathy, bowel sx, and urinary sx. Study approved by PA Department of Health; participants (pts) provided informed consent. Results: Pts average age 57 yrs (80% < 65 yrs), 56% male, 87% white, 67% educated beyond high school, 73% married. 56% had rectal cancer, 51% had chemotherapy, 39% had radiation therapy, 16% had an ostomy. Work status at survey: 226 pts (75%) W; 74 pts (25%) NW. Higher comorbidity number was associated with lower physical (PCS) component scores in both W and NW groups (p = 0.004 and 0.013), and with lower mental (MCS) component scores in the NW group (p = 0.004). Among W pts, predictors of lower PCS were fatigue (p = 0.001), bowel problems (p < 0.001), neuropathy (p = 0.009), and being male (p = 0.03). Predictors of lower MCS were fatigue (p = 0.003), cognitive issues (p < 0.001), and distress (p < 0.001). Among NW pts, predictors of lower PCS were fatigue (p = 0.02), neuropathy (p = 0.007), ostomy presence (p = 0.015), and being unmarried (p = 0.007). Predictors of lower MCS were distress (p < 0.001) and younger age (p = 0.007). Conclusions: Both W and NW CRC survivors have significant comorbidity and sx burden associated with poorer physical and mental functioning. Fatigue, neuropathy, and distress were predictors in both groups, while cognitive and bowel sx predicted poorer function among W survivors. Intervening on these modifiable sx may increase survivors’ return to work and improve functioning for those who do. Next steps will focus on intensive management of modifiable sx to determine the effect on physical and mental functioning and potential for returning to work after treatment.

scholarly journals Outcomes Following Ankle Fracture Fixation With or Without Ankle Arthroscopy

2020 ◽  
Vol 5 (1) ◽  
pp. 247301142090404
Author(s):  
Kenneth S. Smith ◽  
Katherine Drexelius ◽  
Shanthan Challa ◽  
Daniel K. Moon ◽  
Joshua A. Metzl ◽  
...  
Keyword(s):  
Physical Function ◽  
Ankle Fracture ◽  
Ankle Arthroscopy ◽  
Complication Rates ◽  
Function Score ◽  
Anatomic Reduction ◽  
Patient Reported ◽  
Physical Function Score ◽  
Operative Fixation

Background: Ankle fractures are one of the most common orthopedic injuries, and although most patients have a satisfactory outcome following operative fixation, there are patients that have persistent pain despite anatomic reduction. Intra-articular injuries have been suggested as one potential cause of these suboptimal outcomes. Our study assesses the clinical impact of performing an ankle arthroscopy during ankle fracture open reduction and internal fixation (ORIF). Methods: This was a retrospective chart review of all patients who underwent operative fixation of a bimalleolar or trimalleolar ankle fracture at our institution from 2014 through 2018. We extracted all demographic data, fracture pattern, operative procedures performed, tourniquet times, arthroscopic findings and any arthroscopic interventions. We then conducted a phone and e-mail survey. Our study included 213 total patients (142 traditional ORIF, 71 ORIF plus arthroscopy) with an average age of 40 years. The average follow-up was 32.4 months with a survey follow-up rate of 50.7% (110/213). Results: The average tourniquet time for the arthroscopy cohort was 10 minutes longer (89 minutes vs 79 minutes). During the arthroscopy, there was a 28% (20/71) rate of full-thickness osteochondral lesions, 33% (24/71) rate of loose bodies, and a 49% (35/71) rate of partial-thickness cartilage injury. The mean Patient Reported Outcome Information System (PROMIS) physical function score among Weber B fibula fractures was 45.8 and 42.3 in the arthroscopy and nonarthroscopy groups, respectively ( P = .012). In addition, the patient satisfaction rate in Weber B fibula fractures was higher in those patients who underwent arthroscopy compared with ORIF alone (93% vs 75%, P = .05). Patients who had a tibiotalar joint dislocation at the time of the ankle fracture had a significantly higher PROMIS physical function score (46.6 vs 40.2, P = .005) when their surgery included arthroscopy. Conclusion: Ankle arthroscopy at the time of ORIF led to statistically significant improvements in patient-reported outcomes for Weber B fibula fractures and ankle dislocations. There was no increase in complication rates and the arthroscopy took 10 minutes longer on average. Level of Evidence: Level III, retrospective cohort study.

scholarly journals THE EFFECT OF DIACEREIN AND MELOXICAM COMBINATION VERSUS MELOXICAM ALONE ON PHYSICAL FUNCTION IN PATIENTS WITH KNEE OSTEOARTHRITIS

2018 ◽  
Vol 11 (10) ◽  
pp. 325
Author(s):  
Ni Made Oka Dwicandra ◽  
Made Krisna Adi Jaya
Keyword(s):  
Combination Therapy ◽  
Knee Osteoarthritis ◽  
Physical Function ◽  
Therapy Group ◽  
Controlled Trial ◽  
Area Under The Curve ◽  
Combination Group ◽  
Function Score ◽  
Knee Oa ◽  
Physical Function Score

Objective: More than 50% of patients with knee osteoarthritis (OA) had an inadequate pain relief in its management. Combination therapy could be the solution to this problem. The aim of this study was to compare the efficacy of combination therapy of diacerein and meloxicam with meloxicam alone in the patient with knee OA.Methods: A total of 64 knee OA patients were recruited from Rumah Sakit Umum Daerah Dr. Mohammad Soewandhie Surabaya. They were allocated to combination group and single therapy group using randomized controlled trial design. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) physical function questionnaire were assessed in weeks 0–4th. The difference between pre- and post-treatment score and area under the curve (AUC) of WOMAC score were calculated.Results: Combination therapy and single therapy had significant clinical effect with the downregulated score of WOMAC physical function after 4th week (p<0.05). However, there were no differences in AUC of WOMAC physical function score between combination and single therapy.Conclusion: Patient with knee OA could gain beneficial efficacies from combination therapy of diacerein and meloxicam. Studies of longer follow-up time to get the differences in AUC of WOMAC physical function score are needed.

scholarly journals Depression and Pain Interference Correlate With Physical Function in Patients Recovering From Hand Surgery

Hand ◽  
2018 ◽  
Vol 14 (6) ◽  
pp. 830-835 ◽  
Author(s):  
Tom J. Crijns ◽  
David N. Bernstein ◽  
David Ring ◽  
Ronald M. Gonzalez ◽  
Danielle M. Wilbur ◽  
...  
Keyword(s):  
Coping Strategies ◽  
Physical Function ◽  
Patient Reported Outcomes ◽  
Carpal Tunnel Release ◽  
Hand Surgery ◽  
Pain Interference ◽  
Measurement Information ◽  
Function Score ◽  
Patient Reported ◽  
Physical Function Score

Background: Patient-reported outcome measures vary more than expected based on underlying pathology, in part due to the substantial influence of mood and coping strategies. Methods: This study addressed the primary null hypothesis that the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function score 1 month (range, 3-8 weeks) after hand surgery is not associated with PROMIS Depression and PROMIS Pain Interference scores prior to surgery, accounting for other factors. Using an institution-wide database of routinely collected patient-reported outcomes, we identified adult patients who underwent wrist ganglion excision, trapeziometacarpal arthroplasty, hand ganglion excision, trigger digit, De Quervain, and carpal tunnel release. Measures collected included the PROMIS Physical Function Computerized Adaptive Test (CAT), PROMIS Pain Interference CAT, and PROMIS Depression CAT. We sought factors associated with postsurgical PROMIS Physical Function scores and change between preoperative and postoperative score using multivariable linear regression, accounting for age, sex, surgery type, provider, and time from surgery to postsurgical measurement. Results: Higher postoperative PROMIS Physical Function score was independently associated with lower PROMIS Pain Interference scores, lower PROMIS Depression scores, younger age, and treatment by provider team 3. Greater change in PROMIS Physical Function score was independently associated with greater PROMIS Pain Interference scores, greater time from surgery, and treatment by provider team 3. Conclusions: Mood and effective coping strategies affect the level of symptoms and limitations during recovery from hand surgery and represent important treatment opportunities for enhancing recovery.

scholarly journals Pain and Functional Outcome with Single dose 25% Dextrose Intra-Articular Injection in Patients with Primary Osteoarthritis of the Knee

2021 ◽  
Vol 29 (2) ◽  
pp. 138-144
Author(s):  
Ziaur Rahman Chowdhury ◽  
Abul Khair Mohammad Salek ◽  
Moshiur Rahman Khasru ◽  
Farzana Khan Shoma ◽  
SM Mazharul Islam ◽  
...  
Keyword(s):  
Single Dose ◽  
Physical Function ◽  
Statistical Difference ◽  
Functional Improvement ◽  
P Value ◽  
Function Score ◽  
Significant Statistical Difference ◽  
Vas Score ◽  
Initial Stage ◽  
Physical Function Score

Introduction: Osteoarthritis (OA) is the most prevalent chronic joint disorder worldwide and is associated with significant pain and disability. The introduction of 25% Dextrose injection has been viewed as an advance in the management of OA knee. Methods: A prospective, randomized clinical trial was conducted with 84 cases in the Physical Medicine and Rehabilitation (PMR) department of BSMMU. Group A, 42 patients received single dose 25% Dextrose injection intra articular 8ml, exercise and ADL; Group B, 42 patients received exercise and ADL. Outcomes were measured by OA specific translated and validated Bengali instrument- Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire and visual analogue scale (VAS 0-10). They were followed up for 6 months. Result: At the initial stage and in week 4, there was no statistical difference between two groups regarding VAS score (as p value was >0.05). But in week 12 and 24, there was highly significant statistical difference regarding VAS score between two groups as the p value was <0.001. Again at the initial stage and week 4, there was no statistical difference between two groups regarding stiffness and physical function score. But in week 12 and 24, there was significant statistical difference regarding stiffness and physical function score between two groups as the p value was less than 0.05. Conclusion: Intra-articular injection of 25% dextrose administered to patients with OA knee has significant effects in pain reduction and functional improvement. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 138-144

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