Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2022 Mar;103(3):409-417.e2.
doi: 10.1016/j.apmr.2021.07.805. Epub 2021 Aug 21.

Effect of Severe Distal Tibia, Ankle, and Mid- to Hindfoot Trauma on Meeting Physical Activity Guidelines 18 Months After Injury

Kevin H McLaughlin  1 , Stuart L Mitchell  2 , Kristin R Archer  3 , Hiral Master  3 , Saam Morshed  4 , Joshua L Gary  5 , Clifford B Jones  6 , Ellen J MacKenzie  7 , Lisa Reider  7 ; METRC
Affiliations
Observational Study

Effect of Severe Distal Tibia, Ankle, and Mid- to Hindfoot Trauma on Meeting Physical Activity Guidelines 18 Months After Injury

Kevin H McLaughlin et al. Arch Phys Med Rehabil. 2022 Mar.

Abstract

Objective: To examine the effect of severe lower extremity trauma on meeting Physical Activity Guidelines for Americans (PAGA) 18 months after injury and perform an exploratory analysis to identify demographic, clinical, and psychosocial factors associated with meeting PAGA.

Design: Secondary analysis of observational cohort study.

Setting: A total of 34 United States trauma centers PARTICIPANTS: A total of 328 adults with severe distal tibia, ankle and mid- to hindfoot injuries treated with limb reconstruction (N=328).

Interventions: None.

Main outcome measures: The Paffenbarger Physical Activity Questionnaire was used to assess physical activity levels 18 months after injury. Meeting PAGA was defined as combined moderate- and vigorous-intensity activity ≥150 minutes per week or vigorous-intensity activity ≥75 minutes per week.

Results: Fewer patients engaged in moderate- or vigorous-intensity activity after injury compared with before injury (moderate: 44% vs 66%, P<.001; vigorous: 18% vs 29%; P<.001). Patients spent 404±565 minutes per week in combined moderate- to vigorous-intensity activity before injury compared with 224±453 minutes postinjury (difference: 180min per week; 95% confidence interval [CI], 103-256). The adjusted odds of meeting PAGA were lower for patients with depression (adjusted odds ratio [AOR], 0.45; 95% CI, 0.28-0.73), women (AOR, 0.59; 95% CI, 0.35-1.00), and Black or Hispanic patients (AOR, 0.49; 95% CI, 0.28-0.85). Patients meeting PAGA prior to injury were more likely to meet PAGA after injury (odds ratio, 2.0; 95% CI, 1.20-3.31).

Conclusions: Patients spend significantly less time in moderate- to vigorous-intensity physical activity after injury. Patients with depression are less likely to meet PAGA. Although the causal relationship is unclear, results highlight the importance of screening for depression.

Trial registration: ClinicalTrials.gov NCT01606501.

Keywords: Exercise; Rehabilitation; Risk factors.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Flow chart of patients included analysis. Paffenbarger Physical Activity Questionnaire.
See this image and copyright information in PMC

References

    1. Bosse MJ, MacKenzie EJ, Kellam JF, et al. An analysis of outcomes of reconstruction or amputation after leg-threatening injuries. N Engl J Med 2002;347:1924–31. - PubMed
    1. MacKenzie E, Bosse M, Pollak A, et al. Long-term persistence of disability following severe lower-limb trauma: results of a seven-year follow-up. J Bone Joint Surg Am 2005;87:1801–9. - PubMed
    1. Doukas WC, Hayda RA, Frisch HM, et al. The Military Extremity Trauma Amputation/Limb Salvage (METALS) Study: outcomes of amputation versus limb salvage following major lower-extremity trauma. J Bone Joint Surg Am 2013;95:138. - PubMed
    1. Beckenkamp PR, Lin CW, Engelen L, Moseley AM. Reduced physical activity in people following ankle fractures: a longitudinal study. J Orthop Sports Phys Ther 2016;46:235–42. - PubMed
    1. Ekegren CL, Climie RE, Simpson PM, et al. Physical activity and sedentary behavior 6 months after musculoskeletal trauma: what factors predict recovery? Phys Ther 2020;100:332–45. - PubMed

Publication types

Associated data