Bernstein David N, Anderson Michael R, Baumhauer Judith F, Oh Irvin, Flemister A Samuel, Ketz John P, DiGiovanni Benedict F
Department of Orthopaedics and Rehabilitation, University of Rochester, New York.
Foot Ankle Spec. 2019 Aug;12(4):350-356. doi: 10.1177/1938640018806662. Epub 2018 Oct 19.
Achilles tendinopathy is a common clinical disorder. Utilizing the Patient-Reported Outcomes Measurement Information System, we aim to determine clinical response to nonoperative achilles tendinopathy rehabilitative care of insertional achilles tendinopathy compared to non-insertional achilles tendinopathy. Prospective Patient-Reported Outcomes Measurement Information System Physical Function, Pain Interference, and Depression scores were collected for patients with achilles tendinopathy at presentation and following a standard course of nonoperative care. A distribution-based method was used to determine the minimal clinically important difference. Descriptive statistics were reported and bivariate analysis was used to compare insertional achilles tendinopathy and non-insertional achilles tendinopathy. Receiver operating characteristic curve analysis was used to predict clinical improvement. A total of 102 patients with an average follow-up of 68 days were included. For the non-insertional achilles tendinopathy group: Fifteen (46%), 12 (36%) and 9 (27%) patients reached clinical improvement for Physical Function, Pain Interference and Depression, respectively. For the insertional achilles tendinopathy group: Seventeen (25%), 20 (29%) and 22 (32%) patients reached clinical improvement for Physical Function, Pain Interference and Depression, respectively. Physical Function scores improved more in non-insertional achilles tendinopathy patients (4.0 vs. -0.046; p = 0.035) and more patients clinically improved (45.5% vs. 24.6%; p = 0.034). Patients with non-insertional and insertional achilles tendinopathy clinically improved functionally when initial Physical Function scores were equal to or lower than 40.25 and 38.08, respectively. Nonoperative care in achilles tendinopathy is often successful. The Patient-Reported Outcomes Measurement Information System can be used to evaluate and help determine clinical success. Level II: Prospective comparative study.
跟腱病是一种常见的临床病症。利用患者报告结局测量信息系统，我们旨在确定与非插入性跟腱病相比，插入性跟腱病的非手术跟腱病康复护理的临床反应。收集了跟腱病患者就诊时和接受标准非手术护理疗程后的前瞻性患者报告结局测量信息系统的身体功能、疼痛干扰和抑郁评分。采用基于分布的方法确定最小临床重要差异。报告了描述性统计数据，并使用双变量分析比较插入性跟腱病和非插入性跟腱病。使用受试者工作特征曲线分析来预测临床改善情况。共纳入102例患者，平均随访68天。对于非插入性跟腱病组：分别有15例（46%）、12例（36%）和9例（27%）患者在身体功能、疼痛干扰和抑郁方面达到临床改善。对于插入性跟腱病组：分别有17例（25%）、20例（29%）和22例（32%）患者在身体功能、疼痛干扰和抑郁方面达到临床改善。非插入性跟腱病患者的身体功能评分改善更多（4.0对-0.046；p=0.035），临床改善的患者更多（45.5%对24.6%；p=0.034）。当初始身体功能评分分别等于或低于40.25和38.08时，非插入性和插入性跟腱病患者在功能上有临床改善。跟腱病的非手术护理通常是成功 的。患者报告结局测量信息系统可用于评估并帮助确定临床成功情况。二级：前瞻性比较研究。
