Jebeles Garrett, Bernstein Marc, Kelly Tyler, Underwood Meghan, Sanchez Thomas, Schick Samuel, Earla Rishi, Shah Ashish
Department of Orthopedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Iowa Orthop J. 2025;45(1):61-67.
Patients' characteristics, both physical and mental, are proven to have relationships to patient-reported outcomes following orthopaedic surgeries. This study aims to elucidate the impact of resilience, using the Brief Resilience Scale, on patient-reported outcomes following isolated gastrocnemius recession for patients with plantar fasciitis or Achilles tendinopathy with secondary exploratory analysis on factors influencing these outcomes.
Patients were selected utilizing the current procedural terminology code 27687 between 2013-2020. The electronic medical record was reviewed for basic demographics. Patients were contacted for patient-reported outcome measurement information system (PROMIS) scores, foot function index (FFI) scores, and brief resilience scale survey questionnaires. Pearson correlations were used to assess the association of FFI and PROMIS domains. A linear regression model was constructed to evaluate the independent effect of resilience on each FFI and PROMIS outcome instrument. A significance threshold of P < 0.05 was used to determine significance in the regression model.
Increased resiliency showed a significant correlation with increased PROMIS physical function (r = 0.46, p<0.0001), decreased PROMIS pain interference (r = -0.043, p < 0.0001), and decreased PROMIS depression (r= -0.04, p < 0.0001). Increased resiliency showed a significant correlation with decreased FFI activity limitation (r= -0.047, p < 0.0001), decreased FFI disability (r = -0.53, p < 0.0001), decreased FFI pain (r = -0.36, p < 0.0001), and decreased FFI total (r= -0.52, p < 0.0001).
This study demonstrates the positive impact resilience has on patient-reported outcomes following isolated gastrocnemius recession for patients with a clinical diagnosis of either Achilles tendinopathy or plantar fasciitis. We were able to show a moderate correlation between higher resiliency and improved PROMIS and FFI scores for all domains. Optimizing resiliency preoperatively may help to optimize an individual's own surgical outcomes and aid physicians in managing patient expectations following surgery. .
事实证明，患者的身体和心理特征与骨科手术后患者报告的结局相关。本研究旨在使用简易复原力量表，阐明复原力对孤立性腓肠肌松解术后患者报告结局的影响，并对影响这些结局的因素进行二次探索性分析，这些患者患有足底筋膜炎或跟腱病。
利用当前程序术语代码27687在2013年至2020年期间选择患者。查阅电子病历以获取基本人口统计学信息。联系患者以获取患者报告结局测量信息系统（PROMIS）评分、足部功能指数（FFI）评分和简易复原力量表调查问卷。使用Pearson相关性分析来评估FFI与PROMIS各领域之间的关联。构建线性回归模型以评估复原力对每个FFI和PROMIS结局工具的独立影响。回归模型中以P < 0.05的显著性阈值来确定显著性。
复原力增强与PROMIS身体功能增强显著相关（r = 0.46，p<0.0001）、PROMIS疼痛干扰降低（r = -0.43，p < 0.0001）以及PROMIS抑郁降低（r = -0.40，p < 0.0001）。复原力增强与FFI活动受限降低（r = -0.47，p < 0.0001）、FFI残疾降低（r = -0.53，p < 0.0001）、FFI疼痛降低（r = -0.36，p < 0.0001）以及FFI总分降低（r = -0.52，p < 0.0001）显著相关。
本研究证明了复原力对临床诊断为跟腱病或足底筋膜炎的患者在孤立性腓肠肌松解术后患者报告结局具有积极影响。我们能够证明较高的复原力与所有领域中PROMIS和FFI评分的改善之间存在中度相关性。术前优化复原力可能有助于优化个体自身的手术结局，并帮助医生管理患者术后的期望。
