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《使用生活空间移动性评估(LSA)评估老年踝关节骨折的恢复情况:一项初步研究》再版

Republication of "Assessment of Recovery From Geriatric Ankle Fracture Using the Life Space Mobility Assessment (LSA): A Pilot Study".

作者信息

Ahearn Briggs, Mueller Claire, Boden Stephanie, Mignemi Danielle, Tenenbaum Shay, Bariteau Jason

机构信息

Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA.

Orthopaedic Attending with Chaim Sheba Medical Center at Tel Hashomer, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Foot Ankle Orthop. 2023 Aug 19;8(3):24730114231195327. doi: 10.1177/24730114231195327. eCollection 2023 Jul.

Abstract

BACKGROUND

The Life Space Assessment (LSA) is a validated outcomes measure that aims to assess the level of mobility and physical functioning within one's own environment following a medical event. We sought to study the recovery of geriatric ankle fracture patients utilizing the LSA. We hypothesized that the LSA would provide improved assessment of these patients and help identify key differences in operative and nonoperatively treated patients.

METHODS

Prospective observational study of geriatric patients age 65 years and older with an ankle fracture with 1-year follow-up. Operative versus nonoperative intervention was determined by the attending physician on a patient-specific basis. The LSA, Short Form-36 (SF-36), and visual analog pain scale (VAPS) were administered at predetermined intervals postinjury and scores were analyzed for significance.

RESULTS

20 patients were enrolled in this study. 11 underwent surgery whereas 9 were treated nonoperatively. Regardless of treatment, the preinjury LSA score was 86.7. This significantly dropped to 20.6 at 6 weeks and recovered to 73.6 at 12 months. In the operative cohort, the LSA scores preinjury were 91.4 and improved to 87.6 after 1 year. The nonoperative group recorded 80.9 preinjury and only improved to 59.5 at 1 year ( = 0.007). There was no statistically significant difference when comparing the results of the SF-36 and VAPS to the LSA.

CONCLUSION

The LSA was effective in assessing recovery in geriatric ankle fracture patients. A severe deficit in mobility was seen for the first 6 months of recovery regardless of treatment. Operative patients ultimately returned to their baseline LSA at 1 year while nonoperative patients did not. Outcomes from the VAS and SF-36 mirrored the LSA but were not found to be statistically significant.

LEVEL OF EVIDENCE

Level II.

摘要

背景

生活空间评估(LSA)是一种经过验证的结果测量方法,旨在评估医疗事件后个体在自身环境中的活动能力和身体功能水平。我们试图利用LSA研究老年踝关节骨折患者的恢复情况。我们假设LSA能更好地评估这些患者,并有助于识别手术治疗和非手术治疗患者的关键差异。

方法

对65岁及以上的老年踝关节骨折患者进行前瞻性观察研究,随访1年。手术与非手术干预由主治医师根据患者具体情况决定。在受伤后的预定时间间隔使用LSA、简短健康调查问卷(SF-36)和视觉模拟疼痛量表(VAPS),并对得分进行显著性分析。

结果

本研究共纳入20例患者。11例接受手术治疗,9例接受非手术治疗。无论治疗方式如何,受伤前LSA评分为86.7。6周时显著降至20.6,12个月时恢复至73.6。在手术队列中,受伤前LSA评分为91.4,1年后提高到87.6。非手术组受伤前评分为80.9,1年后仅提高到59.5(P = 0.007)。将SF-36和VAPS的结果与LSA进行比较时,没有统计学上的显著差异。

结论

LSA在评估老年踝关节骨折患者的恢复情况方面有效。无论治疗方式如何,在恢复的前6个月均出现严重的活动能力缺陷。手术患者在1年后最终恢复到基线LSA水平,而非手术患者则未恢复。VAS和SF-36的结果与LSA相似,但未发现有统计学显著性。

证据水平

二级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90fe/10467179/475902e45180/10.1177_24730114231195327-fig1.jpg

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