scholarly journals Functional Ankle Instability and Health-Related Quality of Life

2011 ◽  
Vol 46 (6) ◽  
pp. 634-641 ◽  
Author(s):  
Brent L. Arnold ◽  
Cynthia J. Wright ◽  
Scott E. Ross

Context: To our knowledge, no authors have assessed health-related quality of life (HR-QOL) in participants with functional ankle instability (FAI). Furthermore, the relationships between measures of ankle functional limitation and HR-QOL are unknown. Objective: To use the Short Form–36v2 Health Survey (SF-36) to compare HR-QOL in participants with or without FAI and to determine whether HR-QOL was related to functional limitation. Design: Cross-sectional study. Setting: Sports medicine research laboratory. Patients or Other Participants: Sixty-eight participants with FAI (defined as at least 1 lateral ankle sprain and 1 episode of giveway per month) or without FAI were recruited (FAI group: n = 34, age = 25 ± 5 years, height = 1.71 ± 0.08 m, mass = 74.39 ± 12.78 kg, Cumberland Ankle Instability Tool score = 19.3 ± 4; uninjured [UI] group: n = 34, age = 23 ± 4 years, height = 1.69 ± 0.08 m, mass = 67.94 ± 11.27 kg, Cumberland Ankle Instability Tool score = 29.4 ± 1). Main Outcome Measure(s): All participants completed the SF-36 as a measure of HR-QOL and the Foot and Ankle Ability Measure (FAAM) and the FAAM Sport version (FAAMS) as assessments of functional limitation. To compare the FAI and UI groups, we calculated multiple analyses of variance followed by univariate tests. Additionally, we correlated the SF-36 summary component scale and domain scales with the FAAM and FAAMS scores. Results: Participants with FAI had lower scores on the SF-36 physical component summary (FAI = 54.4 ± 5.1, UI = 57.8 ± 3.7, P = .005), physical function domain scale (FAI = 54.5 ± 3.8, UI = 56.6 ± 1.2, P = .004), and bodily pain domain scale (FAI = 52.0 ± 6.7, UI = 58.5 ± 5.3, P < .005). Similarly, participants with FAI had lower scores on the FAAM (FAI = 93.7 ± 8.4, UI = 99.5 ± 1.4, P < .005) and FAAMS (FAI = 84.5 ± 8.4, UI = 99.8 ± 0.72, P < .005) than did the UI group. The FAAM score was correlated with the physical component summary scale (r = 0.42, P = .001) and the physical function domain scale (r = 0.61, P < .005). The FAAMS score was correlated with the physical function domain scale (r = 0.47, P < .005) and the vitality domain scale (r = 0.36, P = .002). Conclusions: Compared with UI participants, those with FAI had less HR-QOL and more functional limitations. Furthermore, positive correlations were found between HR-QOL and functional limitation measures. This suggests that ankle impairment may reduce overall HR-QOL.

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Prachita P. Walankar ◽  
Vrushali P. Panhale ◽  
Kanchi M. Vyas

Abstract Background Functional ankle instability is a common musculoskeletal condition affecting the community. It is characterized by repetitive bouts of giving away, recurrent sprains, and sensation of instability leading to functional deficits in an individual. The present study aimed to assess the influence of kinesiophobia on physical function and quality of life in participants with functional ankle instability. A cross-sectional study was conducted in 30 participants with functional ankle instability. Kinesiophobia was assessed using the 17-item Tampa Scale of Kinesiophobia, physical function using the Foot and Ankle Ability Measure (FAAM) and the FAAM-Sport version (FAAM-S), and quality of life using SF-36. Results The TSK score showed a moderate negative correlation with FAAM-S (r = −0.5, p = 0.005) and a weak negative correlation with SF-36 physical component summary (r = −0.42, p = 0.02). However, TSK showed no significant correlation with FAAM-ADL and SF-36 mental component summary. Conclusion Increased fear of movement, reduced physical function, and health-related quality of life were observed in functional ankle instability individuals. Hence, evaluation of these parameters is imperative in these individuals.


2013 ◽  
Vol 69 (1) ◽  
Author(s):  
J. Schneiderman ◽  
H. Van Aswegen ◽  
P. Becker

To investigate the health-related quality of life (HRQOL) of survivors of major trauma at six months following discharge, using two popular HRQOL tools. A cross-sectional study was done on adult trauma survivors in Johannesburg. Subjects completed the EQ-5D and SF-36 HRQOL questionnaires. Additional demographic and clinical data were collected. The majority of subjects reported some problems in usual activities and pain/discomfort as measured with the EQ-5D at six months. The mean EQ-5D VAS was 68 (±26.1). lowest scores were reported in the role physical (44.6 ± 41.6) and role emotional (44.1 ± 45.4) domains of the SF-36. mean SF-36 physical component summary (PCS) score (62.1 ± 27.8) was higher than mental component summary score (58.7 ±20.1). EQ-5D VAS was found to be moderately correlated with age (r=-0.4; p=0.05). A negative correlation was found between SF-36 physical function score and ICU length of stay (LOS), hospital LOS and age (r=-0.4 (p=0.03), -0.4 (p=0.03) and -0.6 (p=0.00) respectively). Statistical significance was observed in the correlation between age and SF-36 general health domain (r=-0.4; p=0.02) as well as age and PCS score (r=-0.5; p=0.01). Trauma survivors in Johannesburg experience limitations in specific emotional and physical domains of HRQOL at six months after discharge. Age was associated with the level of self-rated health as well as limitations in general health and physical function. ICU and hospital LOS were associated with limitations in physical function. There is a need for physical and psychological rehabilitation after discharge from trauma intensive care.


2014 ◽  
Vol 41 (6) ◽  
pp. 1067-1076 ◽  
Author(s):  
Clifton O. Bingham ◽  
Michael Weinblatt ◽  
Chenglong Han ◽  
Timothy A. Gathany ◽  
Lilianne Kim ◽  
...  

Objective.To evaluate the effects of intravenous (IV) golimumab 2 mg/kg + methotrexate (MTX) on patient-reported measures of health-related quality of life (HRQOL) in patients with active rheumatoid arthritis (RA) despite prior MTX therapy.Methods.In this randomized, multicenter, double-blind, placebo-controlled, phase III trial, adults with RA were randomly assigned to receive IV placebo (n = 197) or golimumab 2 mg/kg (n = 395) infusions at Week 0, Week 4, and every 8 weeks thereafter. All patients continued stable oral MTX (15–25 mg/wk). HRQOL assessments included Health Assessment Questionnaire-Disability Index (HAQ-DI; physical function), Medical Outcomes Study Short Form-36 questionnaire physical/mental component summary (SF-36 PCS/MCS) scores, EQ-5D assessment of current health state, Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) questionnaire, and disease effect on productivity [10-cm visual analog scale (VAS)].Results.Mean HAQ-DI improvements from baseline were significantly greater with golimumab + MTX than placebo + MTX at Week 14 and Week 24 (p < 0.001). Significantly greater improvements in all 8 individual SF-36 subscores and both the SF-36 PCS and MCS scores (p < 0.001) also accompanied golimumab + MTX therapy. Improved EQ-5D and EQ-5D VAS (p < 0.001) and FACIT-Fatigue (p < 0.001) scores were also observed for golimumab + MTX-treated patients at Week 12, Week 16, and Week 24, and greater proportions of golimumab + MTX-treated patients had clinically meaningful improvements in these measures. Greater reductions in disease effect on productivity were observed with golimumab + MTX versus placebo + MTX at Week 24 (p < 0.001). Improvements in physical function, HRQOL, fatigue, and productivity significantly correlated with disease activity improvement.Conclusion.In active RA, IV golimumab + MTX significantly improved physical function, HRQOL, fatigue, and productivity using multiple measurement tools; all correlated with improvements in disease activity (NCT00973479, EudraCT 2008-006064-11).


2019 ◽  
Vol 46 (11) ◽  
pp. 1458-1461 ◽  
Author(s):  
Iain B. McInnes ◽  
Lluís Puig ◽  
Alice B. Gottlieb ◽  
Christopher T. Ritchlin ◽  
Michael Song ◽  
...  

Objective.Evaluate enthesitis, physical function, and health-related quality of life (HRQOL) among patients with psoriatic arthritis (PsA) who are naive to anti–tumor necrosis factor agents.Methods.In PSUMMIT 1 and 2, patients with PsA were randomized to placebo or ustekinumab 45 mg or 90 mg. Enthesitis was assessed at weeks 0 and 24 (Maastricht Ankylosing Spondylitis Enthesitis Score). Assessments included Health Assessment Questionnaire–Disability Index (HAQ-DI), Medical Outcomes Study Short Form-36 (SF-36) physical component summary/mental component summary (PCS/MCS), and American College of Rheumatology 20 (ACR20).Results.At Week 24, 21 had worsened enthesitis, 158 had improved enthesitis, and 412 had unchanged enthesitis. Improved enthesitis was associated with improvements in HAQ-DI and SF-36 MCS. Results were similar for ACR20 responders and nonresponders.Conclusion.Improvement in enthesitis at Week 24 was associated with improvements in physical function/HRQOL regardless of ACR20 response.


2012 ◽  
Vol 39 (7) ◽  
pp. 1450-1457 ◽  
Author(s):  
VIBEKE STRAND ◽  
DINESH KHANNA ◽  
JASVINDER A. SINGH ◽  
ANNA FORSYTHE ◽  
N. LAWRENCE EDWARDS

Objective.To assess the efficacy of pegloticase on pain, physical function, and health-related quality of life (HRQOL) in patients with refractory chronic gout.Methods.Subjects in 2 replicate, 6-month, randomized controlled phase III trials received intravenous infusions of pegloticase 8 mg twice monthly (biweekly group), pegloticase alternating with placebo (8-mg monthly group), or placebo. Medical Outcomes Study Short Form-36 (SF-36), Health Assessment Questionnaire-Disability Index (HAQ-DI), patient global assessment of disease activity (PtGA), and pain by visual analog scale were completed at weeks 1 (baseline), 13, 19, and 25. Prespecified pooled analyses of patient-reported outcomes were performed by combining values for each treatment group (biweekly treatment, monthly treatment, and placebo) at Week 25.Results.Of 212 patients enrolled, 157 (74.1%) completed treatment. At entry, mean age was 55.4 years (range 23–89 yrs) and mean plasma uric acid was 9.7 mg/dl; most were male (81.6%) and white (67.5%). Subjects reported an average of 9.8 flares in the previous 18 months. Baseline SF-36 physical component summary (PCS) scores were > 1.5 SD below US normative values. At Week 25, mean changes from baseline in PtGA, pain, HAQ-DI, and PCS scores were statistically significant and exceeded minimum clinically important differences (MCID) in the biweekly treatment group, compared with little to no improvement in placebo group. Statistically significant improvements greater than or equal to MCID were reported in 6 of 8 SF-36 domains. Monthly pegloticase resulted in significantly improved PtGA, HAQ-DI, PCS, and 3 SF-36 domains.Conclusion.Pegloticase therapy resulted in statistically significant and clinically meaningful improvements in PtGA, pain, physical function, and HRQOL.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Brita Stanghelle ◽  
Hege Bentzen ◽  
Lora Giangregorio ◽  
Are Hugo Pripp ◽  
Astrid Bergland

Abstract Background Osteoporosis and vertebral fractures represent a major health burden worldwide, and the prevalence of osteoporosis is expected to increase as the world’s population ages. Suffering from vertebral fracture has a substantial impact on the individual’s health-related quality of life (HRQoL), physical function and pain. Complex health challenges experienced by older people with osteoporosis and vertebral fractures call for identification of factors that may influence HRQoL, as some of these factors may be modifiable. The objective is to examine the independent associations between HRQoL, physical function and pain in older women with osteoporosis and vertebral fracture. Methods This study has a cross-sectional design, using data from 149 home-dwelling Norwegian women with osteoporosis and vertebral fracture, aged 65+. Data on HRQoL (Short Form 36 (SF-36), Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41)), physical function (walking speed, balance and strength), pain, as well as sociodemographic information were collected. Simple linear regression analyses were conducted and multivariable regression models were fitted to investigate the associations. Results Lower levels of HRQoL were significantly associated with lower levels of physical function, measured by walking speed, and higher levels of pain. Pain was significantly associated with all of the subscales in SF-36, with the exception of Mental Health and Mental Component Score, and all the subscales of QUALEFFO-41. Walking speed was significantly associated with 5 of 8 subscales of SF-36 (except Bodily Pain, Vitality, Mental Health and Mental Component Score), and with 4 of 6 subscales of QUALEFFO-41 (except Score Pain and Mood). Conclusion This study shows that pain and walking speed were, independently of one another, associated with HRQoL in older women with osteoporosis and vertebral fracture. These findings can inform clinicians and health managers about the importance of pain management and exercise interventions in health care for this group. Future research should address interventions targeting both physical function and pain with HRQoL as an outcome. Registration ClincialTrials.gov Identifier: NCT02781974. Registered 18.05.16. Retrospectively registered.


2013 ◽  
Vol 40 (4) ◽  
pp. 369-378 ◽  
Author(s):  
Michael E. Weinblatt ◽  
Arthur Kavanaugh ◽  
Mark C. Genovese ◽  
David A. Jones ◽  
Theresa K. Musser ◽  
...  

Objective.To assess the influence of fostamatinib on patient-reported outcomes (PRO) in patients with active rheumatoid arthritis and an inadequate response to methotrexate (MTX).Methods.Patients taking background MTX (N = 457) were enrolled in a phase II clinical trial (NCT00665925) and randomized equally to placebo, fostamatinib 100 mg twice daily (bid), or fostamatinib 150 mg once daily (qd) for 24 weeks. Self-administered PRO measures included pain, patient's global assessment (PtGA) of disease activity, physical function, health-related quality of life (HRQOL), and fatigue. Mean change from baseline and a responder analysis of the proportion of patients achieving a minimal clinically important difference were determined.Results.At Week 24, there were statistically significant improvements in pain, PtGA, physical function, fatigue, and the physical component summary of the Medical Outcomes Study Short Form-36 (SF-36) for fostamatinib 100 mg bid compared with placebo. Mean (standard error) changes from baseline in the fostamatinib 100 mg bid group versus the placebo group were −31.3 (2.45) versus −17.8 (2.45), p < 0.001 for pain; −29.1 (2.26) versus −16.7 (2.42), p < 0.001 for PtGA; −0.647 (0.064) versus −0.343 (0.062), p < 0.001 for physical function; 7.40 (1.00) versus 4.50 (0.94), p < 0.05 for fatigue; 8.52 (0.77) versus 4.90 (0.78), p < 0.01 for SF-36 physical component score; and 3.99 (0.93) versus 3.71 (0.99), p = 0.83 for SF-36 mental component score. Patients receiving fostamatinib 150 mg qd showed improvements in some PRO, including physical function.Conclusion.Patients treated with fostamatinib 100 mg bid showed significant improvements in HRQOL outcomes.


2020 ◽  
Vol 55 (7) ◽  
pp. 733-738
Author(s):  
Kyle B. Kosik ◽  
Nathan F. Johnson ◽  
Masafumi Terada ◽  
Abbey C. Thomas-Fenwick ◽  
Carl G. Mattacola ◽  
...  

Context People with chronic ankle instability (CAI) display a lower regional and global health-related quality of life (HRQoL). Examinations of HRQoL outcomes associated with CAI have addressed younger adults, restricting our understanding of the long-term consequences of CAI. Objective To compare ankle regional and global HRQoL in middle-aged participants with and those without CAI. Design Cross-sectional study. Setting Laboratory. Patients or Other Participants A total of 59 middle-aged volunteers, consisting of 18 with CAI (age = 50.2 ± 9.3 years), 17 who were ankle-sprain copers (age = 54.5 ± 8.7 years), and 24 uninjured controls (age = 56.7 ± 10.0 years). Main Outcome Measure(s) Participants completed the Foot and Ankle Disability Index (FADI) and the Patient-Reported Outcomes Measurement Information System Adult Profile. Regional HRQoL was assessed using the FADI Activities of Daily Living and Sport subscales. Global HRQoL was measured using the 43-item Patient-Reported Outcomes Measurement Information System Adult Profile, which contains 7 short forms—Physical Function, Pain Interference, Fatigue, Depression, Sleep Disturbance, Anxiety, and Ability to Participate in Social Roles and Activities. Separate Kruskal-Wallis tests were used to determine between-groups differences. Results Middle-aged participants with CAI had lower scores on both subscales of the FADI than the coper and control groups (all P values &lt;.001). Participants with CAI scored lower on the Physical Function (U = 116.0, z = −2.78, P = .005) and Ability to Participate in Social Roles and Activities (U = 96.0, z = −3.09, P = .002) subscales but higher on the Pain Interference (U = 144.0, z = −2.36, P = .02), Fatigue (U = 110.0, z = −2.72, P = .006), and Depression (U = 110.5, z = −2.91, P = .004) subscales than the control group. Participants with CAI also scored lower on the Physical Function (U = 74.5, z = −2.79, P = .005) and Ability to Participate in Social Roles and Activities (U = 55.0, z = −3.29, P = .001) subscales but higher on the Fatigue (U = 90.0, z = −2.09, P = .04) and Depression (U = 96.5, z = −1.97, P = .048) subscales than the coper group. Conclusions Middle-aged participants with CAI displayed worse ankle regional and global HRQoL than their age-matched healthy counterparts and copers. These results demonstrated that CAI can affect HRQoL outcomes in middle-aged adults.


2020 ◽  
Vol 30 (04) ◽  
pp. 230-236
Author(s):  
Mohammad Hadadi ◽  
Farzaneh Heghighat ◽  
Iman Hossein

Abstract Introduction People with chronic ankle instability (CAI) have decreased health-related quality of life (HRQOL), but the differences in HRQOL status between subgroups of CAI have not been determined. This observational, cross-sectional study aimed to evaluate and compare physical, social and psychological aspects of HRQOL in subgroups of patients with CAI. Methods Ninety patients with CAI and 30 healthy participants were included. The patients were assigned to 3 subgroups with functional ankle instability (FAI), mechanical ankle instability (MAI), or mixed functional and mechanical instability (MIX), based on the talar tilt test, anterior drawer test, and Cumberland Ankle Instability Tool score. Participants completed the self-assessed Foot and Ankle Ability Measure (FAAM), Tampa Scale of Kinesophobia-11 (TSK-11), Fear-Avoidance Beliefs Questionnaire (FABQ), and Short-Form Health Survey (SF‑36). Results Significant differences were observed between healthy participants and each CAI subgroup in regional (FAAM), psychological (TSK-11 and FABQ) and global (SF-36) measures (p<0,05). The MIX subgroup had a significantly lower score on the FAAM-sport component, and a higher score on the TSK-11 and FABQ (p<0,05), than the FAI subgroup. There were no diffirences between other CAI subgroups in quality of life measures. Conclusions Patients with MAI and FAI had similar functional deficits in activities of daily living and sport activities, and greater fear of re-injury. The MIX subgroup had greater deficits in sport activities and greater fear of re-injury than the FAI subgroup.


2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0007
Author(s):  
James Lachman ◽  
Samuel Adams ◽  
James DeOrio ◽  
Mark Easley

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.


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