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Physical Performance Limitations After Severe Lower Extremity Trauma in Military Service Members.

Abstract：

OBJECTIVES:To characterize the type and magnitude of lower extremity physical performance deficits in military service members who have undergone rehabilitation after limb salvage or transtibial amputation. DESIGN:Cross-sectional prospective. SETTING:Level I trauma military medical and rehabilitation center. PATIENTS/PARTICIPANTS:Service members with lower extremity trauma resulting in limb salvage (n = 20) or unilateral transtibial amputation (n = 14) compared with uninjured actively training service members (n = 123). INTERVENTION:Control participants and individuals with amputation were tested during a single session. Participants with limb salvage were tested with and without the use of a custom carbon fiber orthosis. MAIN OUTCOME MEASUREMENTS:Physical performance as measured using four-square step, sit-to-stand 5 times, and timed stair ascent tests. Secondary outcomes included the associations between these lower extremity activity measures to determine the interrelationship of activity limitations. RESULTS:The ability of service members to rapidly ascend stairs, a demanding lower limb mobility task, is limited after amputation and limb salvage. However, performance on an agility test similar to the four-square step test approximated normative levels. Differences between individuals with amputation or limb salvage were less than 1 second for all tests and were not statistically significant. Correlations were observed among the physical performance measures in the tested patient populations, particularly between the sit-to-stand and timed stair ascent tests. CONCLUSIONS:Severe limb trauma significantly affects performance, particularly during tasks requiring lower extremity strength and power. Individuals with amputation or limb salvage who were provided a custom carbon fiber orthosis and intensive rehabilitation had similar performance. LEVEL OF EVIDENCE:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

journal_name

J Orthop Trauma

journal_title

Journal of orthopaedic trauma

authors

Wilken JM,Roy CW,Shaffer SW,Patzkowski JC,Blanck RV,Owens JG,Hsu JR

doi

10.1097/BOT.0000000000001103

subject

Has Abstract

pub_date

2018-04-01 00:00:00

pages

183-189

issue

eissn

0890-5339

issn

1531-2291

journal_volume

pub_type

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Physical Performance Limitations After Severe Lower Extremity Trauma in Military Service Members.