To assess functional outcome and using gait analysis to quantify kinematic and kinetic abnormalities of servicemen who suffered foot injuries due to combat actions.
ID
Source
Brief title
Condition
- Fractures
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
- The mean (SD) step width, step length, step frequency and average self-paced
speed.
- The mean (SD) range of motion of ankle (dorsal/plantar flexion and
ab-/adduction).
- Peak Power ankle joint (W/kg)
Secondary outcome
- Physical Performance tests: the CHAMP, existing of
- The SLS:the amount of time an individual can stand on one lower limb. The
patient performs at least 1 trial for each lower limb and up to 3 trials for
each lower limb. Once 30s is achieved with one lower limb, no further trials
will be performed for that limb.
- The ESST: it measures the number of lateral shifts over 4 meter completed in
10 s. The best of 3 trials will be calculated.
- The TT: The patient sprints 10 meters forwards, 5 meters to the right, 10
meters to the left, 5 meters to the right 10 meters backward (T-shape). The
best of 3 trials will be calculated.
- The IAT: the participant runs forward and back 10 m, weave up and back
through a middle row of 4 cones and repeat the forward and back 10 meters run
to conclude the test. The length and width of the course is 10 m by 5 m. The
best of 3 trials will be calculated.
The CHAMP scoring system produces *CHAMP Scores* with a range from 0 to 10 for
each of the 4 items. The converted *CHAMP Scores *of the 4 CHAMP items are
added together to produce a composite or Total CHAMP Score ranging from 0 to 40
with 40 representing the highest level of performance and 33 * representing the
threshold level of performance equivalent to Active Duty Service Members.
- Lower Extremity Functional Scale (LEFS); The LEFS is a 20-item
condition-specific questionnairede signed for individuals with musculoskeletal
conditions of the lower extremity. Each item of the LEFS scores on a 5-point
scale ranging from 0 to 4 points, 0 being an *extreme difficulty or unable to
perform activity* and 4 being *no difficulty*.
Background summary
During combat operations, injuries to the extremities require the greatest
medical resources, disable the most servicemen and have the biggest disability
benefit costs. The size and scale of ankle and foot injury is profound. Foot
injuries have a significant effect on quality of life in poly-trauma patients.
Fifty-eight Dutch servicemen who suffered combat-related injuries during
operation *Task Force Uruzgan* (TFU) received a rehabilitation program in the
Military Rehabilitation Center (MRC). Mobility measured by the Lower Extremity
Functional Scale (LEFS) accounts for 51% of health related quality of life
(HRQoL) 2.5 years after the incident. Guidelines for foot and ankle
rehabilitation are limited in this population.
Study objective
To assess functional outcome and using gait analysis to quantify kinematic and
kinetic abnormalities of servicemen who suffered foot injuries due to combat
actions.
Study design
Observational study.
The GRAIL (Gait Real-time Analysis Interactive Lab) system will be used to
measure walking-speed, step parameters and joint angles. Physical performance
tests will be performed; The Comprehensive High-Level Activity Mobility
Predictor (CHAMP). The CHAMP consists of 4 tests: Single Limb Stance (SLS), the
Edgren Side Step Test (ESST), the T-Test (TT) and the Illinois Agility Test
(IAT). The Lower extremity functional scale (LEFS) will be filled out by the
participant. The relationship between gait parameters, physical performance
tests and the LEFS will be calculated.
To test whether or not there is a significant difference in the mean outcome
for the group with foot injuries compared to the normal group on gait analysis
parameters and performance tests, the t-tests will be used when there is a
normal distribution and the Mann-Whitney when there is not a normal
distribution,
The influence of determinants on the LEFS the Pearson correlation coefficient
will be used. It will calculate the correlation between variables and the LEFS.
Study burden and risks
The subjects have to visit the rehabilitation centre once and will perform mild
physical exertion (walking) and physical performance tests. The duration of
mild physical exertion is 12 minutes in total; at fixed and self paced speed.
The physical performance tests will take approximately 18 minutes. Total
duration of the session will be 60 minutes. Since subjects walk on a treadmill
and are suspended by a safety harness system overhead which prevents the
subject from falling, the risks are negligible.
Since no kinetic and kinematic data are known for blast-related foot injuries,
insight in these might benefit future surgical interventions and rehabilitation
programs.
Heidelberglaan 100
Utrecht 3584 CX
NL
Heidelberglaan 100
Utrecht 3584 CX
NL
Listed location countries
Age
Inclusion criteria
Dutch servicemen who sustained talus and/or calcaneus and/or navicular fractures on one or both sides in Afghanistan as a result of combat actions and were repatriated because of their injuries.
A control group of 14 healthy servicemen will be included, matched on age and sex, without a history of orthopaedic, neurological or vascular injury of back or lower extremities.
Exclusion criteria
1) Not being able to walk barefoot
2) Visual impairments that can affect gait.
3) One sided amputation of the lower extremity.
4) Injury to the central nervous system.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL49481.028.15 |