Impact of Lower Limb Fractures on the Quality of Life

2019 ◽  
Vol 21 (1) ◽  
pp. 33-40
Author(s):  
Marilia de Andrade Fonseca ◽  
Amanda Gilvani Cordeiro Matias ◽  
Maria de Lourdes de Freitas Gomes ◽  
Marcos Almeida Matos
Keyword(s):  
Quality Of Life ◽  
Functional Capacity ◽  
Lower Limb ◽  
Lower Limbs ◽  
Prolonged Treatment ◽  
Level Of Education ◽  
Lower Limb Fractures ◽  
Limb Fractures ◽  
Emotional Impairment

Background. Lower limb fractures are associated with severe disability, prolonged treatment and recovery time, and account for the greatest number of surgical procedures. Studies focusing on the health related quality of life (HRQOL) of patients who sustained lower limb fractures at a productive age are still scarce. The aim of the present study was to assess the HRQOL of individuals who sustained lower limb fractures at two time points: during the acute trauma period (hospitalization) and after six months. Materials and methods. A prospective observational longitudinal study was conducted including a total of 121 patients aged 18 years or older with fractures in the lower limbs evaluated based on clinical and sociodemographic variables and using the HRQOL questionnaire SF-36. The data were collected from referral trauma hospitals in two stages: during hospitalization (in-hospital period) and from the same individuals six months after the first interview. Results. At six months following the trauma, significant differences were found for the domains of functional capacity (from 2.77±7.82 to 51.11±28.43), pain (47.51±35.51 to 74.29±21.63), and emotional impairment (57.01±47.62 to 91.22±22.92) in the study period. However, no improvement was observed in the domains of physical limitations and social aspects. There was significant association for the domain “Pain” with age, level of education, and rehabilitation; the domain “Emotional impairment” was associated with treatment within 10 hours, level of education, and immediate osteosynthesis. At six months, only functional capacity exhibited significant associations with the level of education and rehabilitation. Conclusion. Lower limb fractures have a negative impact on the HRQOL that persists for at least six months after the traumatic event and is reflected in the psychosocial, physical and emotional burden imposed by the trauma.

scholarly journals Time to debridement in open high-grade lower limb fractures and its effect on union and infections: A prospective study in a tropical setting

2020 ◽  
Vol 28 (1) ◽  
pp. 230949902090755
Author(s):  
Christina Marie Joseph ◽  
Thilak Samuel Jepegnanam ◽  
Boopalan Ramasamy ◽  
Vinoo Mathew Cherian ◽  
Manasseh Nithyananth ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lower Limb ◽  
Short Form ◽  
Care Center ◽  
Tertiary Care ◽  
High Grade ◽  
Lower Limb Fractures ◽  
Sf 36 ◽  
Limb Fractures

Purpose: To prospectively evaluate whether time to debridement has any correlation with union, infection, and quality of life in high-grade lower limb fractures in a tropical setting. Methods: A prospective cohort study was conducted at a tertiary care center in South India. Two hundred fifty-four adult skeletally mature patients with 301 grade 3 fractures involving the femur, tibia, or fibula were recruited. The cohort was empirically divided into two groups (early and late) based on the time to debridement (less than or more than 12 h from injury). Outcome: The primary outcome was nonunion. Secondary outcomes were deep infection rates and patients’ quality of life. Short form-36 (SF-36) and short musculoskeletal functional assessment (SMFA) questionnaires were also used. Patients were followed up for 9 months. Results: The follow-up rate was 93%. The late group had a significantly higher risk of nonunion (odds ratio(OR): 6.5, 95% confidence interval (CI): 2.82–14.95) and infections (OR: 6.05, 95% CI: 2.85–12.82). There was a 4% increase in the infection risk for each hour of delay for the initial 50 h ( p < 0.0001). SF-36 and SMFA scores were superior in the early group ( p < 0.0001). Conclusion: The study contradicts findings reported in the literature from the West. Our study was in agreement with our hypothesis and proved that debridement within 12 h resulted in significantly lower rates of nonunion and infections and an overall improved quality of life in high-grade open lower limb fractures in a developing country. Level of evidence: Level II Trial registration: German Clinical Trials Register DRKS00015186

scholarly journals Effectiveness of lower limb rehabilitation protocol using mobile health on quality of life, functional strength and functional capacity among knee osteoarthritis patients who were overweight and obese: A randomized controlled trial

2022 ◽  
Author(s):  
Muhammad Tariq Rafiq ◽  
Mohamad Shariff A Hamid ◽  
Eliza Hafiz
Keyword(s):  
Quality Of Life ◽  
Mobile Health ◽  
Functional Capacity ◽  
Lower Limb ◽  
Rehabilitation Protocol ◽  
Daily Care ◽  
Strengthening Exercises ◽  
Limb Rehabilitation ◽  
Lower Limb Rehabilitation

Objective: This study aimed to investigate the effectiveness of the lower limb rehabilitation protocol (LLRP) using mobile health (mHealth) on quality of life (QoL), functional strength, and functional capacity among knee OA patients who were overweight and obese. Materials and Methods: In the current trial, 114 patients were recruited and randomized into either the rehabilitation group with mobile health (RGw-mHealth) receiving reminders by using mHealth to carry on the strengthening exercises of LLRP and instructions of daily care (IDC), the rehabilitation group without mobile health (RGwo-mHealth) following the strengthening exercises of LLRP and instructions of daily care (IDC) and control group (CG) only following the IDC for duration of 12-weeks. The reminders for using mHealth were provided two times a day for three days a week. Primary outcome measures were QoL assessed by the Western Ontario and McMaster Universities Osteoarthritis Index summary score, and functional strength by Five-Repetition Sit-To-Stand Test. Secondary outcome measure was functional capacity assessed by the Gait Speed Test. The assessments of QoL, functional strength, and functional capacity were taken at baseline and posttest after 12-weeks of intervention. Results: After 12 weeks of intervention, patients in all three groups had statistically significant improvement in QoL within groups (p < 0.05). Furthermore, patients in the RGw-mHealth and RGwo-mHealth had statistically significant improvement in functional strength and walking gait speed within groups (p < 0.05). The pairwise between-group comparisons (Bonferroni post hoc test) of the mean changes in QoL, functional strength, and functional capacity at posttest assessments revealed that patients in the RGw-mHealth had statistically significant greater mean change in QoL, functional strength and functional capacity relative to both the RGwo-mHealth and CG (p < 0.001). Conclusion: Improvement in QoL, functional strength, and functional capacity was larger among patients in the RGw-mHealth compared with the RGwo-mHealth or CG. Keywords: Osteoarthritis, knee, overweight, rehabilitation. mobile health.

Development of a Lower Limb Orthosis to Form Neuromuscular Patterning

2014 ◽  
Author(s):  
Karla A. Camarillo–Gómez ◽  
Gerardo I. Pérez-Soto ◽  
Luis A. Torres-Rico
Keyword(s):  
Quality Of Life ◽  
Control System ◽  
Lower Limb ◽  
Gait Cycle ◽  
Lower Cost ◽  
Sagittal Plane ◽  
Lower Limbs ◽  
Human Gait

In this paper, a lower limb orthosis is proposed to form the human gait neuromuscular patterns in patients with myelomeningocele. The orthosis has two lower limbs of 2–DOF each which reduces the motion of the hip and knee to the sagittal plane. The orthosis are assembled in a back support which also supports the patients weight. The control system for the orthosis allows to reproduce in a repetitive, controlled and autonomous way the human gait cycle at different velocities according to the patient requirements; so that, the neuromuscular patterning can be supervised by a therapist. The development of these orthosis seeks to improve the quality of life of those infants with myelomenigocele and to introduce a lower cost Mexican technology with Mexican anthropometric dimensions.

scholarly journals Muscular weakness represents the main limiting factor of walk, functional independence and quality of life of myelopathy patients associated to HTLV-1

2016 ◽  
Vol 74 (4) ◽  
pp. 280-286 ◽  
Author(s):  
Renata Costa Caiafa ◽  
Marco Orsini ◽  
Lilian R. Felicio ◽  
Marzia Puccioni-Sohler
Keyword(s):  
Quality Of Life ◽  
Functional Capacity ◽  
Short Form ◽  
Functional Dependence ◽  
Functional Independence ◽  
Lower Limbs ◽  
Daily Activities ◽  
Limiting Factor ◽  
Adductor Muscles

ABSTRACT HTLV-1-associated myelopathy is a progressive disabling disease associated with gait abnormalities. Objective To identify and quantify the main muscles affected by weakness and spasticity, their impact on gait, functional capacity and on quality of life of HTLV-1-associated myelopathy patients. Method We evaluated lower limbs muscular strength according to the Medical Research Council scale, spasticity according to the modified Ashworth scale, daily activities according to the Barthel Index and quality of life according to the Short-Form Health Survey-36 of 26 HTLV-1-associated myelopathy patients. Results The muscles most affected by weakness included the dorsal flexors and knee flexors. Spasticity predominated in the hip adductor muscles and in plantar flexors. Assistance for locomotion, minimal dependence in daily activities, limitations in functional capacity and physical aspects were the most common findings. Conclusion The impairment of gait, functional dependence and quality of life were predominantly a consequence of intense muscle weakness in HTLV-1-associated myelopathy patients.

scholarly journals Quality of life, body image and self-esteem in patients with unilateral transtibial amputations

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nuria Sarroca ◽  
José Valero ◽  
Javier Deus ◽  
Josefa Casanova ◽  
María José Luesma ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Image ◽  
Lower Limb ◽  
Self Esteem ◽  
Lower Limb Amputation ◽  
Lower Limbs ◽  
Limb Amputation ◽  
Control Group ◽  
Life Questionnaire

AbstractAmputation represents a drastic impact on the patient’s body and perception. This cross-sectional study aims to analyse the aesthetic concern represented by body image, self-esteem and quality of life in patients with unilateral transtibial amputations of lower limbs compared to control group. People living with amputations present lower average levels than controls in all subscales of the SF-36 (Short Form 36 Health Survey) quality of life questionnaire, and in both the physical component summary and the mental component summary, although the difference is not statistically significant in the latter. These patients present a significantly lower mean score (p = 0.002) in the MBSRQ (Body-Self Relations Questionnaire) body image questionnaire: 2.64 ± 0.49 opposed to 3.16 ± 0.55 in controls. People living with amputations had a lower mean score on the Rosenberg Self-Esteem scale than controls (34.44 ± 4.61 v 36.04 ± 3.63). The results also show that amputation has a significant influence on the BI (Body image) of patients with unilateral transtibial amputations. SE (Self-Esteem) seems to be an aspect that is not significantly affected by lower limb amputation, although these patients scored a lower mean on the RSE scale compared to the control group. We consider it is highly relevant to assess QoL (Quality of life), BI and SE in patients after a lower limb amputation process.

scholarly journals QUALITY OF LIFE OF PATIENTS UNDERGOING SURGICAL TREATMENT OF LOWER LIMB CANCER

2021 ◽  
Author(s):  
Maria Iakovleva ◽  
◽  
Olga Shchelkova ◽  
Ekaterina Usmanova ◽  
◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Lower Limb ◽  
General Health ◽  
Soft Tissues ◽  
Bodily Pain ◽  
Lower Limbs ◽  
High Tech ◽  
Coping Scale

"Patients suffering from oncological diseases are the focus of attention of both physicians and psychologists. Although tumor lesions of bones and soft tissues are a relatively rare condition, its effect on the person’ mind and lifestyle are significant, and its treatment is a challenge, also in terms of patient’s adaptation to the disease and therapy. There are various strategies for treating this pathology; all of them are associated with high-tech medicine focused on maintaining or improving patients’ quality of life (QoL). The aim of the present research is to study the psychological characteristics and QoL of patients undergoing surgical treatment of tumor lesions of bones and soft tissues of lower limbs. Material and methods. 36 patients were examined (mean age 58,22; 19 – men). The SF-36 questionnaire, Ways of Coping Questionnaire (WCQ), and Big Five Personality Test (BFI) were used. Treatment by means of the isolated limb perfusion technique was prescribed to 15 patients (group 1); 21 patients were subjected to lower limb amputation due to their disease (group 2). Results. It was found that patients who underwent amputation are characterized by lower rates on the coping scale ‘accepting responsibility’ than patients from the perfusion group (p < 0.05); at the same time, patients from the second group had higher values on the ‘openness’ scale of the BFI compared to the first group (p < 0.1). The study of the relationship between patients’ QoL parameters, personality and coping showed that in the first group the values on the coping scale ‘seeking social support’ negatively correlate with ‘bodily pain’ (p < 0.01), and ‘escape–avoidance’ negatively correlates with ‘social functioning’ (p < 0.01). In the second group, the following significant correlations between personality traits and QoL were revealed: ‘extraversion’ is positively associated with ‘physical functioning’, ‘role-emotional’ and ‘mental health’ (p < 0.01), ‘agreeableness’ has a negative correlation with ‘bodily pain’ and ‘general health’ (p < 0.01), ‘neuroticism’ is negatively related with ‘bodily pain’ and ‘general health’ (p < 0.01), ‘openness’ is positively associated with ‘bodily pain’ and ‘general health’ (p < 0.01). Conclusion. The data obtained emphasizes the importance of taking into account personality characteristics in the management of patients with cancer, including tumor lesions of the bones and soft tissues, as well as the dynamic nature of QoL and its close interconnection with the stage and strategy of treatment and patients’ personality. Psychological support for patients is required for their successful adaptation to the illness and therapy. Acknowledgement. This research was supported by the Russian Foundation for Basic Research (RFBR) (Grant No 20-013-00573)."

scholarly journals Simple assessment of quality of life and lower limb functional capacity during cilostazol treatment – results of the SHort-tERm cIlostazol eFFicacy and quality of life (SHERIFF) study

VASA ◽  
2020 ◽  
Vol 49 (3) ◽  
pp. 235-242 ◽  
Author(s):  
Katalin Farkas ◽  
Endre Kolossváry ◽  
Zoltán Járai
Keyword(s):  
Quality Of Life ◽  
Clinical Practice ◽  
Intermittent Claudication ◽  
Functional Capacity ◽  
Lower Limb ◽  
Ankle Brachial Index ◽  
Walking Distance ◽  
Treatment Results ◽  
Walking Capacity

Summary: Background: Symptomatic peripheral arterial disease (intermittent claudication) is a major cause of disability and mobility loss in older men and women and thus has a significant negative impact on the patients’ quality of life. Both surgical and endovascular revascularization procedures and noninvasive medical therapies, such as supervised training and drug treatment, can improve walking capacity. Cilostazol is the only drug having a class I (level of evidence A) recommendation for the treatment of intermittent claudication (IC). The aim of this study was to evaluate the effect of three-month cilostazol treatment on the health-related quality of life and on the lower limb functional capacity in patients with IC in the clinical practice. Patients and methods: The study was a multicenter, non-interventional trial, performed in Hungary in 2018. 812 PAD patients (Fontaine II stage, mean age: 67.17 years, male/female: 58.25/41.75 %) were enrolled, who received cilostazol (50 or 100 mg b.i.d.) for 3 months. 802 patients completed the study. Quality of life was evaluated with the EQ-5D-3L questionnaire functional capacity with the WELCH (Walking Estimated-Limitation Calculated by History) questionnaire. Pain-free and maximal walking distance, ankle-brachial index (ABI) were measured at baseline and after 3-month treatment. Results: Upon conclusion of the study, the EQ-5D-3L index improved (baseline: –0.46 ± 0.22, 3rd month: –0.26 ± 0.18; p < 0.0001) and there was a significant increase in the WELCH score as well (19 ± 14, 31 ± 18; respectively, p < 0.0001). Both pain-free and maximal walking distance improved significantly by 54.52 % (median: 53.85 %) and 42.5 % (median: 34.68 %); respectively (p < 0.001). Adverse events occurred in 10 patients, 1 patient stopped cilostazol treatment because of side effects. Conclusions: Three months cilostazol treatment significantly improved quality of life and lower limb functional capacity in patients with intermittent claudication. The WELCH questionnaire is a useful tool for the evaluation of intermittent claudication treatment in the clinical practice.

scholarly journals Study on the correlation between knee osteoarthritis and anxiety in patients aged over 55

2020 ◽  
pp. 95-104
Author(s):  
Lavinia DUICA ◽  
Juliánna SZAKÁCS ◽  
SILIȘTEANU Sînziana Călina
Keyword(s):  
Quality Of Life ◽  
Knee Osteoarthritis ◽  
Functional Capacity ◽  
Muscle Tone ◽  
Demographic Data ◽  
Lower Limbs ◽  
Reduction Of Pain ◽  
Recovery Treatment ◽  
Joint Rigidity

Introduction. Osteoarthritis, which is a cause of chronic pain and disability with manifestation in any joint, with greater frequency in the joints of the lower limbs, upper limbs, but also at the spine level , affects around 250 million people in the entire world. This condition affects around 10% of the global population (18) and has an impressive impact on people, as it is one of the first 5 causes of disability. Material and method. The objectives of the treatment made by the patients diagnosed with knee osteoarthritis were: pain reduction, increased joint amplitude, increased muscle strength, increased muscle tone, increased quality of life and reintegration into the family and social environment. In the study, there were discussed demographic data regarding the patients. In order to assess the pain parameter, the VAS scale was used, as well as WOMAC subscales. To assess the quality of life of patients with knee osteoarthritis, the QOL scale (Quality of Life) was used. Anxiety was assessed with the help of a test that comprises the evaluation of symptoms at the cognitive, behavioral and physical level. Results and discussions. The pain was evaluated on the VAS scale, having a statistically significant evolution for the evaluation moments. Also with the help of the WOMAC index, two other parameters were evaluated, namely joint rigidity and functional capacity, the results being statistically significant in the 3 evaluation moments. The patients’ anxiety was evaluated with the help of the anxiety test; the results obtained were statistically significant at the 3 evaluation moments. Conclusions. It is vital that the recovery treatment in osteoarthritis be individualized and adapted to the age group. In our group, it enabled the reduction of pain and anxiety, the increase of the functional capacity and the quality of the patients’ lives.Taking into account the fact that the most affected group in the study group was the active professional one, we can evaluate the size of the recovery and the social, family and professional integration for these patients.

scholarly journals d-Dimer as a Screening Marker for Venous Thromboembolism After Surgery Among Patients Younger Than 50 With Lower Limb Fractures

2016 ◽  
Vol 23 (1) ◽  
pp. 78-83 ◽  
Author(s):  
Yong Yang ◽  
Pengfei Zan ◽  
Jinpeng Gong ◽  
Ming Cai
Keyword(s):  
Venous Thromboembolism ◽  
Lower Limb ◽  
Significant Risk ◽  
Lower Limbs ◽  
Cutoff Value ◽  
Vein Thrombosis ◽  
Lower Limb Fractures ◽  
Duration Of Surgery ◽  
Limb Fractures ◽  
D Dimer

Objective: For the present study, the authors hypothesized that the d-dimer levels would be systematically raised in a postoperative population of patients younger than 50 with lower limb fractures and to define a feasible cutoff value for identification of venous thromboembolism (VTE). Methods: Doppler ultrasonography of lower limbs was performed pre- and postoperatively to evaluate for deep vein thrombosis in 150 patients who underwent open reduction and internal fixation (ORIF). Plasma d-dimer levels were assessed 2 days before surgery and on the 3rd, 7th, and 10th days after surgery. Statistical analysis was carried out to define a feasible threshold for the d-dimer levels. Results: Plasma d-dimer levels were found to be systematically raised postoperatively, and they differed between patients with and without VTE significantly. On the third day after surgery, d-dimer levels of more than 3 mg/L indicated VTE with a sensitivity of 88.37% and a specificity of 96.96%, allowing for the definition of a feasible cutoff value. Duration of surgery, duration of tourniquet, ventilation time, and time of postoperative immobility of lower limbs were identified as highly significant risk factors for the development of VTE. Conclusion: Using a threshold of 3 mg/L, the d-dimer levels will screen out VTE with a high degree of sensitivity and specificity in younger patients who have undergone ORIF for lower limb fractures.

Sign in / Sign up

Export Citation Format

Share Document