By Emily Delzell
An integrated orthotic and rehabilitation program for soldiers with severe lower extremity trauma improves physical function and pain and decreases consideration of late amputation, even when patients begin it more than two years after injury.
Investigators from the San Antonio Military Medical Center in Texas developed this Return to Run protocol and the customized energy-storing orthosis it utilizes. They prospectively evaluated 84 service members (53 less than and 31 more than two years after injury) with lower extremity fractures, nerve injury with weakness, and arthritis who completed four weeks of physical therapy alone followed by four weeks of physical therapy wearing the orthosis.
At eight weeks all patients experienced significant improvements in pain and physical function compared with baseline, and 41 of the 50 who had been considering amputation at the start of the study favored continued limb salvage. Patients who sustained injuries more than two years before starting the program had similar improvement to those who began earlier.
Clinical Orthopaedics and Related Research epublished the results on April 18.
Bedigrew KM, Patzkowski JC, Wilken JM, et al. Can an integrated orthotic and rehabilitation program decrease pain and improve function after lower extremity trauma? Clin Orthop Relat Res 2014 Apr 18. [Epub ahead of print]