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Can an integrated orthotic and rehabilitation program decrease pain and improve function after lower extremity

Katherine M Bedigrew1, Jeanne C Patzkowski, Jason M Wilken

  • 1Department of Orthopaedics, San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX, 78234, USA, kattcain2010@yahoo.com.

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Summary
This summary is machine-generated.

An 8-week integrated orthotic and rehabilitation program significantly improved physical performance and reduced pain for lower extremity trauma patients. Improvements were sustained long-term, even for those over two years post-injury, reducing amputation considerations.

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Area of Science:

  • Orthopedics
  • Rehabilitation Medicine
  • Biomechanical Engineering

Background:

  • Severe lower extremity trauma leads to long-term disability and potential amputation.
  • Current rehabilitation methods may not fully address functional deficits.
  • Energy-storing orthoses show promise, but their integration with rehabilitation over time is understudied.

Purpose of the Study:

  • To assess if an 8-week integrated orthotic and rehabilitation initiative improves physical performance, pain, and outcomes in patients with lower extremity deficits.
  • To determine if recovery differs between patients enrolled early versus more than two years after injury.
  • To evaluate the initiative's impact on reducing consideration of late amputation.

Main Methods:

  • Prospective evaluation of 84 service members with lower extremity trauma.
  • An 8-week program: 4 weeks of physical therapy followed by 4 weeks with an energy-storing orthosis.
  • Assessment using validated physical performance tests and patient-reported outcomes at baseline, 4, and 8 weeks.

Main Results:

  • Significant improvements were observed in all physical performance measures and patient-reported outcomes by week 8.
  • Patients enrolled less than and greater than two years post-injury showed similar improvement magnitudes.
  • Of 50 patients considering amputation, 41 favored limb salvage after the 8-week intervention.

Conclusions:

  • The integrated orthotic and rehabilitation initiative effectively improved physical function, reduced pain, and enhanced outcomes for severe lower extremity trauma.
  • Improvements were sustained and comparable for patients over two years post-injury.
  • Further research is needed to implement this program in civilian settings and for long-term outcomes.