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.
Keywords
List of abbreviations:
AOR (adjusted odds ratio), CI (confidence intervals), METALS (Military Extremity Trauma Amputation/Limb Salvage), MET (metabolic equivalent), OUTLET (Outcomes After Severe Distal Tibia, Ankle, and/or Foot Trauma), PAGA (Physical Activity Guidelines for Americans), PPAQ (Paffenbarger Physical Activity Questionnaire), PTSD (posttraumatic stress disorder)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 20, 2021
Accepted:
July 15,
2021
Received in revised form:
July 9,
2021
Received:
January 14,
2021
Footnotes
Supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant no. T32 AR067708) and the Department of Defense (grant no. W81XWH-10-2-0090).
Clinical Trial Registration No.: For original OUTLET study - NCT01606501.
Disclosures: none
Identification
Copyright
© 2021 Published by Elsevier Inc. on behalf of The American Congress of Rehabilitation Medicine.
