Correlation of Physical Performance and Patient-Reported Outcomes Following Total Ankle Arthroplasty

McConnell, Evan; Queen, Robin M.

doi:10.1177/1071100716672656

Cited by 23 publications

(25 citation statements)

References 59 publications

(131 reference statements)

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“…24,30 Similarly, pain and pain interference scores are improved and approach normal levels 6-24 months following TAA. 23,24,30 The present study results suggest normative levels of depression and pain interference can be expected longer-term. Overall, patient scores that were close to the population mean on the majority of examined health domains adds to the already positive literature regarding TAA outcomes.…”

Section: Discussionsupporting

confidence: 55%

Overall Health and the Influence of Physical Therapy on Physical Function Following Total Ankle Arthroplasty

et al. 2020

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Background: The overall health and the importance of physical therapy for people following total ankle arthroplasty (TAA) have been understudied. Our purpose was to characterize the overall health of patients following TAA, and explore the frequency, influence, and patient-perceived value of physical therapy. Methods: People who received a TAA participated in this retrospective cohort online survey study. The survey included medical history questions and items from the Patient-Reported Outcomes Measurement Information System (PROMIS) Short Forms. Seven PROMIS domains, reflecting the biopsychosocial model of care (physical, mental, social), were included to examine participant overall health status in comparison to the general population. Items regarding physical therapy participation (yes/no), number of visits, and perceived value (scale 0-10; 10 = extremely helpful) were also included. Descriptive statistics were generated for participant characteristics, PROMIS domain T scores, and physical therapy questions. The influence of participant characteristics or physical therapy visits on PROMIS domain T scores that scored below the population mean were examined with multiple linear regression or ordinal regression. Results: The response rate was 61% (n=95). Average postoperative time was approximately 3 years (mean [SD]: 40.0 [35.3] months). Physical function and ability to participate in social roles and activities domain T scores were at least 1 SD below the population mean. Most patients received physical therapy (86%; 17.1 [11.0] visits) and found it helpful (7.2 [3.0]). Participant characteristics were minimally predictive of physical function and social participation T scores. Number of physical therapy visits predicted physical function T scores ( P = .03). Conclusions: Most health domain scores approached the population mean. Physical therapy was perceived to have a high value, and greater visits were related to greater physical function. However, lower physical function and social participation scores suggest that postoperative care directed toward these domains could improve the value of TAA and promote overall health. Level of Evidence: Level III, retrospective comparative study.

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Section: Discussionsupporting

confidence: 55%

Overall Health and the Influence of Physical Therapy on Physical Function Following Total Ankle Arthroplasty

et al. 2020

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“…The work summarized above shows that interventions for ankle OA are effective relative to re‐interventions. One way the current studies of ankle OA and gait may contribute most effectively is through the use of simple measures of physical performance such as walking speed, balance, and the four square step test that can provide insight into patient function that are not obtained from standard patient reported outcomes . Clinicians can collect simple measures of function, specifically walking speed and balance, to assess patient outcomes, and determine the need for future therapeutic interventions.…”

Section: Ankle Arthritis and Lower Extremity Biomechanicsmentioning

confidence: 99%

Directing clinical care using lower extremity biomechanics in patients with ankle osteoarthritis and ankle arthroplasty

Queen

2017

Journal Orthopaedic Research

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Ankle osteoarthritis is a debilitating disease with approximately 50,000 new cases per year leading to skeletal deformity, severe and recurrent pain, cartilage breakdown, and gait dysfunction limiting patient mobility and well-being. Although many treatments (total ankle arthroplasty [TAA], ankle fusion [arthrodesis], and ankle distraction arthroplasty) relieve pain, it is not clear that these procedures significantly improve patient mobility. The goal of the research presented here is to summarize what is presently known about lower extremity gait mechanics and outcomes and to quantify the impact of ankle osteoarthritis and TAA have on these measures using an explicitly holistic and mechanistic approach. Our recent studies have explored physical performance and energy recovery and revealed unexpected patterns and sequelae to treatment including incomplete restoration of gait function. These studies demonstrated for the first time the extreme levels and range of gait and balance dysfunction present in ankle osteoarthritis patients as well as quantifying the ways in which the affected joint alters movement and loading patterns not just in the painful joint, but throughout both the ipsilateral and contralateral lower extremity. Through this work, we determined that relieving pain alone through TAA is not enough to restore normal walking mechanics and balance due to underlying causes including limited ankle range of motion and balance deficits leading to long-term disability despite treatment. The results indicate the need to consider additional therapeutic interventions aimed at restoring balance, ankle range of motion, and movement symmetry in order to improve long-term health and function. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2345-2355, 2017.

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“…Clinical outcomes [2,8,21], radiographic alignment [8,32], and survival rates [2,32] of some implants have been assessed, but few gait analysis studies have examined longitudinal functional and biomechanical outcomes associated with TAA [6,[23][24][25]27]. Patient-reported outcomes and the assessment of physical performance are important for understanding surgical outcomes because they provide complementary information [19]. Although patient-reported outcomes have been assessed in multiple studies [3,7,9,[24][25][26]29], few studies have directly compared the effect of implant type on gait mechanics after TAA [27,29].…”

Section: Introductionmentioning

confidence: 99%

Are There Differences in Gait Mechanics in Patients With A Fixed Versus Mobile Bearing Total Ankle Arthroplasty? A Randomized Trial

Queen

Franck

Schmitt

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Correlation of Physical Performance and Patient-Reported Outcomes Following Total Ankle Arthroplasty

Abstract: Level IV, cohort study.

Cited by 23 publications

References 59 publications

Overall Health and the Influence of Physical Therapy on Physical Function Following Total Ankle Arthroplasty

Overall Health and the Influence of Physical Therapy on Physical Function Following Total Ankle Arthroplasty

Directing clinical care using lower extremity biomechanics in patients with ankle osteoarthritis and ankle arthroplasty

Are There Differences in Gait Mechanics in Patients With A Fixed Versus Mobile Bearing Total Ankle Arthroplasty? A Randomized Trial

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