Functional assessment and influencing factors after staged functional training in patients with ankle fractures

BACKGROUND The recovery of limb function after ankle fracture surgery is a gradual process.The main purpose of implementing early functional exercise,joint mobility,muscle contraction function,passive ankle flexion and extension exercises,or physical factor therapy techniques is to achieve the rapid recovery of normal physiological limb function.However,currently the most effective rehabilitation training method is staged limb functional exercise,which promotes rapid recovery of limb function while preventing adverse consequences caused by overwork or insufficient training.Staged limb functional exercise divides the rehabilitation process into multiple stages,each of which has specific training objectives and contents.This method helps patients gradually restore limb function.Nevertheless,some patients still exhibit poor limb function after standardized exercise.Therefore,a functional evaluation should be performed to analyze the impact of staged functional training after ankle fracture surgery.AIM To perform a functional evaluation and determine the influencing factors of staged functional training in patients with ankle fracture.METHODS A retrospective study enrolled 150 patients who underwent surgical treatment for ankle fracture from May 2020 to May 2022 at our hospital.Univariate and multivariate linear regression analyses were performed on general data,functional exercise compliance scale for orthopedic patients,Social Support Rating Scale(SSRS),American Orthopedic Foot and Ankle Score(AOFAS)Ankle-Hindfoot Score,and pain factors[serum bradykinin(BK),prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT)].RESULTS Based on the AOFAS Ankle-Hindfoot Scale,the cases were divided into the excellent function(n=111)and ordinary function(n=39)groups.Univariate analysis revealed that monthly family income,education level,diabetes mellitus,functional exercise compliance scale of orthopedic patients score,SSRS,BK,PGE2,and 5-HT significantly influenced limb function after ankle fracture(P<0.05);Multiple linear regression analysis showed that the functional exercise compliance scale score,SSRS,BK,PGE2,and 5-HT were independent risk factors affecting functional performance after staged functional exercise(P<0.05).CONCLUSION Exercise compliance,SSRS,and pain level are the independent risk factors affecting functional performance after staged functional training following ankle surgery.Clinical nursing care after ankle surgery should include analgesic and health education measures to ensure optimal recovery of limb function.

The effect of baduanjin exercise in rehabilitation for functional ankle instability:A study protocol for a randomized controlled pilot trial

Introduction:Patients with functional ankle instability(FAI)have problems with joint control,balance,gait,and postural symmetry.Baduanjin is a type of traditional Chinese exercise that has been shown to be effective in treating many diseases and symptoms.However,to date,the effect of Baduanjin in patients with FAI has not been proved.This pilot trial is an assessor-blinded randomized controlled trial,and its objective is to study the efficacy and safety of Baduanjin on the rehabilitation of patients with FAI.Methods:Seventy-two participants,who are eligible according to specified inclusion and exclusion criteria,will be randomized(in a 1:1 ratio),using a random number table,into two groups:a Baduanjin group and a conventional treatment group.The Baduanjin group will be subjected to the Baduanjin exercise in addition to the conventional treatment therapy.Participants’exercise programs will be implemented for 4 weeks(5 days a week).All participants will be assessed at baseline,and after two and 4 weeks of treatment.The surface electromyography results of the bilateral erector spinae,tibialis anterior,and peroneus longus will be the primary outcomes,while the balance function under different conditions and the level of FAI in daily life measured using the Cumberland Ankle Instability Tool will be the secondary outcomes.Ethics and Dissemination:The trial has been approved by the Research Ethical Committee of Dongzhimen Hospital,the First Affiliated Hospital of Beijing University of Chinese Medicine(no.DZMEC-KY-2019-18),and it will follow the principles of the Consolidated Standards of Reporting Trials statements as well as the Declaration of Helsinki.The findings of this study will be submitted for publication in peer-reviewed journals.The results will also be disseminated to the participants via phone calls or e-mail.

Gait improvement after treadmill training in ischemic stroke survivors A critical review of functional MRI studies

Stroke survivors often present with abnormal gait, movement training can improve the walking performance post-stroke, and functional MRI can objectively evaluate the brain functions before and after movement training. This paper analyzes the functional MRI changes in patients with ischemic stroke after treadmill training with voluntary and passive ankle dorsiflexion. Functional MRI showed that there are some changes in some regions of patients with ischemic stroke including primary sensorimotor cortex, supplementary motor area and cingulate motor area after treadmill training. These findings suggest that treadmill training likely improves ischemic stroke patients＇ lower limb functions and gait performance and promotes stroke recovery by changing patients＇ brain plasticity; meanwhile, the novel treadmill training methods can better training effects.

Management of a rare giant cell tumor of the distal fibula: A case report

BACKGROUND Aggressive giant cell tumor of the distal fibula is so rare that no consensus on a surgical strategy has been reached.Thus,an appropriate treatment strategy is still important to discuss.CASE SUMMARY A 61-year-old man who had been experiencing progressive swelling of the left lateral malleolus accompanied by pain for half a year was presented at our hospital.He had never been treated prior to coming to our hospital.Preoperative imaging revealed a 10 cm×6 cm mass located in the body of the distal fibula.Pathological biopsies confirmed it was a giant cell tumor.Preoperative examination revealed he had dilated cardiomyopathy with class 3 cardiac function.The cardiologist and anesthesiologist determined that he could tolerate the operation,but the operation should be as short and minimally invasive as possible.With the patient’s consent,we performed a tibiotalar fusion and followed up with him for 2years,finding no recurrence and a satisfactory recovery.CONCLUSION Tibial talus fusion is an effective method for the treatment of distal fibula tumors.

Effects of electroacupuncture on the proprioception of athletes with functional ankle instability

Objective To observe the efficacy differences between electroacupuncture （EA） and physiotherapy （PT） on the proprioception of athletes with functional ankle instability （FAI）. Methods Fifty athletes with FAI were randomly divided into an EA group and a PT group. The EA group was treated with EA at Jiexi （解溪 ST 41）, Kunlun （昆仑 BL 60）, Qjuxu （丘墟 GB 40） and Ashi points, and the PT group was treated with low frequency electrical stimulation and infrared radiation at medial malleolus and lateral malleolus, thrice each week for consecutive 8 weeks. The joint position sense： active （JPSA）, joint position sense： passive （JPSP） and Kinaesthesia （KT） were assessed at the ankle by use of Biodex System isokinetic dynamometer to test the proprioception before and after the treatment. Results In the EA group, JPSA of 11.09°±3.1° and JPSP of 9.67°±2.8° before the treatment were reduced to 9.14°±4.0° and 6.89°±3.3° respectively after the treatment, and there were statistically significant differences in comparison between pre- and post-treatment （all P〈0.05）. Comparison between the EA group and the PT group, there were significant differences in JPSA and JPSP （all P〈0.05）, no significant difference in KT （P〉0.05）. There were no significant differences in the indices of JPSA, JPSP and KT in the PT group after the treatment than those before the treatment （all P〉0.05）. Conclusion EA can effectively improve the proprioception of athletes with FAI and achieve a better efficacy as compared with the conventional physiotherapy.