Association Between Intracompartmental Pressures in the Deep Posterior Compartment of the Leg and Conservative Treatment Outcome for Exercise-Related Leg Pain in Military Service Members
Objective: To evaluate the relationship between intracompartmental pressure (ICP) values of the deep posterior compartment and the outcomes of a comprehensive conservative outpatient treatment program in service members with chronic exercise-related leg pain. Design: Historic cohort study. Setting:...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-12-01
|
| Series: | Archives of Rehabilitation Research and Clinical Translation |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590109522000647 |
| _version_ | 1811206850247393280 |
|---|---|
| author | Mats J.L. van der Wee, BSc Sanne Vogels, MD Eric W.P. Bakker, PhD Francis G. O'Connor, MD, MPH Rigo Hoencamp, MD, PhD Wes O. Zimmermann, MD, PhD |
| author_facet | Mats J.L. van der Wee, BSc Sanne Vogels, MD Eric W.P. Bakker, PhD Francis G. O'Connor, MD, MPH Rigo Hoencamp, MD, PhD Wes O. Zimmermann, MD, PhD |
| author_sort | Mats J.L. van der Wee, BSc |
| collection | DOAJ |
| description | Objective: To evaluate the relationship between intracompartmental pressure (ICP) values of the deep posterior compartment and the outcomes of a comprehensive conservative outpatient treatment program in service members with chronic exercise-related leg pain. Design: Historic cohort study. Setting: Department of sports medicine at a military secondary care facility. Participants: During the 5-year study period, 266 military patients completed a treatment program for chronic exercise-related leg pain. Eighty-three service members with 145 affected legs met all inclusion criteria (N=83; 59 men, 24 women; median age, 22 years). Main Outcome Measures: The primary outcome measure was return to active duty. The secondary outcome measure was development of acute on chronic compartment syndrome. A generalized linear mixed model was used to identify predictor variables associated with return to active duty, including ICP values of the deep posterior compartment and Single Assessment Numeric Evaluation (SANE) score. Results: Sixty service members (72%) successfully returned to active duty. No association between ICP values of the deep posterior compartment and treatment outcome was found (odds ratio, 1.02; 95% confidence interval, 0.97-1.07; P=.50). A low SANE score (ie, more severe symptoms at baseline) was negatively associated with primary outcome (odds ratio, 0.95; 95% confidence interval, 0.90-0.99; P=.01). None of the patients developed acute on chronic compartment syndrome during the treatment program. Conclusions: There was no association between a single postexercise ICP value of the deep posterior compartment of both legs in military service members and return to active duty after a comprehensive conservative outpatient treatment program. None of the patients developed acute on chronic compartment syndrome. In this population, ICP measurement of the deep posterior compartment can be safely postponed until conservative treatment fails and surgical treatment is considered. |
| first_indexed | 2024-04-12T03:53:46Z |
| format | Article |
| id | doaj.art-50307ea263ed48d08640f4b84743b621 |
| institution | Directory Open Access Journal |
| issn | 2590-1095 |
| language | English |
| last_indexed | 2024-04-12T03:53:46Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Archives of Rehabilitation Research and Clinical Translation |
| spelling | doaj.art-50307ea263ed48d08640f4b84743b6212022-12-22T03:48:53ZengElsevierArchives of Rehabilitation Research and Clinical Translation2590-10952022-12-0144100232Association Between Intracompartmental Pressures in the Deep Posterior Compartment of the Leg and Conservative Treatment Outcome for Exercise-Related Leg Pain in Military Service MembersMats J.L. van der Wee, BSc0Sanne Vogels, MD1Eric W.P. Bakker, PhD2Francis G. O'Connor, MD, MPH3Rigo Hoencamp, MD, PhD4Wes O. Zimmermann, MD, PhD5Department of Surgery, Alrijne Hospital, Leiderdorp, the Netherlands; Trauma Research Unit, Department of Trauma Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Corresponding author Mats van der Wee, BSc, Alrijne Hospital, Department of Surgery, Simon Smitweg 1, 2353 GA Leiderdorp, the Netherlands.Department of Surgery, Alrijne Hospital, Leiderdorp, the Netherlands; Trauma Research Unit, Department of Trauma Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the NetherlandsDivision of Clinical Methods and Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, the NetherlandsDepartment of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MDDepartment of Surgery, Alrijne Hospital, Leiderdorp, the Netherlands; Trauma Research Unit, Department of Trauma Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Defense Healthcare Organization, Ministry of Defense, Utrecht, the Netherlands; Department of Surgery, Leiden University Medical Center, Leiden, the NetherlandsDepartment of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD; Royal Netherlands Army, Department of Sports Medicine, Utrecht, the NetherlandsObjective: To evaluate the relationship between intracompartmental pressure (ICP) values of the deep posterior compartment and the outcomes of a comprehensive conservative outpatient treatment program in service members with chronic exercise-related leg pain. Design: Historic cohort study. Setting: Department of sports medicine at a military secondary care facility. Participants: During the 5-year study period, 266 military patients completed a treatment program for chronic exercise-related leg pain. Eighty-three service members with 145 affected legs met all inclusion criteria (N=83; 59 men, 24 women; median age, 22 years). Main Outcome Measures: The primary outcome measure was return to active duty. The secondary outcome measure was development of acute on chronic compartment syndrome. A generalized linear mixed model was used to identify predictor variables associated with return to active duty, including ICP values of the deep posterior compartment and Single Assessment Numeric Evaluation (SANE) score. Results: Sixty service members (72%) successfully returned to active duty. No association between ICP values of the deep posterior compartment and treatment outcome was found (odds ratio, 1.02; 95% confidence interval, 0.97-1.07; P=.50). A low SANE score (ie, more severe symptoms at baseline) was negatively associated with primary outcome (odds ratio, 0.95; 95% confidence interval, 0.90-0.99; P=.01). None of the patients developed acute on chronic compartment syndrome during the treatment program. Conclusions: There was no association between a single postexercise ICP value of the deep posterior compartment of both legs in military service members and return to active duty after a comprehensive conservative outpatient treatment program. None of the patients developed acute on chronic compartment syndrome. In this population, ICP measurement of the deep posterior compartment can be safely postponed until conservative treatment fails and surgical treatment is considered.http://www.sciencedirect.com/science/article/pii/S2590109522000647Chronic exertional compartment syndromeConservative treatmentMilitary personnelOccupational medicineRehabilitationRunning |
| spellingShingle | Mats J.L. van der Wee, BSc Sanne Vogels, MD Eric W.P. Bakker, PhD Francis G. O'Connor, MD, MPH Rigo Hoencamp, MD, PhD Wes O. Zimmermann, MD, PhD Association Between Intracompartmental Pressures in the Deep Posterior Compartment of the Leg and Conservative Treatment Outcome for Exercise-Related Leg Pain in Military Service Members Archives of Rehabilitation Research and Clinical Translation Chronic exertional compartment syndrome Conservative treatment Military personnel Occupational medicine Rehabilitation Running |
| title | Association Between Intracompartmental Pressures in the Deep Posterior Compartment of the Leg and Conservative Treatment Outcome for Exercise-Related Leg Pain in Military Service Members |
| title_full | Association Between Intracompartmental Pressures in the Deep Posterior Compartment of the Leg and Conservative Treatment Outcome for Exercise-Related Leg Pain in Military Service Members |
| title_fullStr | Association Between Intracompartmental Pressures in the Deep Posterior Compartment of the Leg and Conservative Treatment Outcome for Exercise-Related Leg Pain in Military Service Members |
| title_full_unstemmed | Association Between Intracompartmental Pressures in the Deep Posterior Compartment of the Leg and Conservative Treatment Outcome for Exercise-Related Leg Pain in Military Service Members |
| title_short | Association Between Intracompartmental Pressures in the Deep Posterior Compartment of the Leg and Conservative Treatment Outcome for Exercise-Related Leg Pain in Military Service Members |
| title_sort | association between intracompartmental pressures in the deep posterior compartment of the leg and conservative treatment outcome for exercise related leg pain in military service members |
| topic | Chronic exertional compartment syndrome Conservative treatment Military personnel Occupational medicine Rehabilitation Running |
| url | http://www.sciencedirect.com/science/article/pii/S2590109522000647 |
| work_keys_str_mv | AT matsjlvanderweebsc associationbetweenintracompartmentalpressuresinthedeepposteriorcompartmentofthelegandconservativetreatmentoutcomeforexerciserelatedlegpaininmilitaryservicemembers AT sannevogelsmd associationbetweenintracompartmentalpressuresinthedeepposteriorcompartmentofthelegandconservativetreatmentoutcomeforexerciserelatedlegpaininmilitaryservicemembers AT ericwpbakkerphd associationbetweenintracompartmentalpressuresinthedeepposteriorcompartmentofthelegandconservativetreatmentoutcomeforexerciserelatedlegpaininmilitaryservicemembers AT francisgoconnormdmph associationbetweenintracompartmentalpressuresinthedeepposteriorcompartmentofthelegandconservativetreatmentoutcomeforexerciserelatedlegpaininmilitaryservicemembers AT rigohoencampmdphd associationbetweenintracompartmentalpressuresinthedeepposteriorcompartmentofthelegandconservativetreatmentoutcomeforexerciserelatedlegpaininmilitaryservicemembers AT wesozimmermannmdphd associationbetweenintracompartmentalpressuresinthedeepposteriorcompartmentofthelegandconservativetreatmentoutcomeforexerciserelatedlegpaininmilitaryservicemembers |