Formal Physical Therapy Improves Patient-Reported Outcome Measurement Information System Physical Function for High...

Area of Science:

• Orthopedic surgery outcomes research
• Patient-reported outcome measures
• Anxiety and pain management in orthopedic recovery

Background:

• Ankle fractures are common injuries requiring surgical fixation.
• Patient-reported outcome measures (PROMIS) like anxiety scores (AS) can influence recovery.
• The role of formal physical therapy (PT) in conjunction with anxiety levels post-ankle fracture fixation is not well-defined.

Purpose of the Study:

• To compare outcomes of ankle fracture fixation based on PT provision (formal vs. none).
• To compare outcomes based on PROMIS anxiety score levels (high vs. low).
• To evaluate the effect of PT within different PROMIS anxiety score strata.

Main Methods:

• Retrospective cohort study of 161 adult patients undergoing isolated ankle fracture fixation.
• PROMIS scores for physical function (PF) and pain interference (PI) were analyzed.
• Subgroup analysis compared patients receiving PT versus no PT across high and low anxiety groups.

Main Results:

• Formal PT did not significantly impact PROMIS PF or PI scores compared to no PT.
• High anxiety patients reported significantly worse PROMIS PI scores than low anxiety patients.
• After controlling for age, high anxiety patients receiving no PT (HANP) had significantly lower PROMIS PF than other groups; high anxiety patients generally had worse PI.

Conclusions:

• High anxiety is associated with worse pain interference after ankle fracture fixation, regardless of PT.
• Formal PT may offer some functional benefits for high anxiety patients.
• Anxiety assessment and targeted interventions could be crucial for optimizing recovery after ankle fracture fixation.