Accelerating Recovery Following a Lower Extremity Fracture Through Speed HIIT
Abstract
Objectives and Rationale: The objective of this study is to test a novel intervention that can be administered early during recovery following a traumatic fracture that can improve the ability Soldiers to return to work/duty, functional capabilities, and their patient-reported outcomes. To accomplish these goals we have combined a speed walking intervention originally used to treat patients with a neurological condition with high-intensity interval training. By combining the two interventions, we are able to harness the power of both to result in improved motor planning through the speed walking with the physical training of the high-intensity interval training program. The proposed program has another distinct advantage, as it is affordable and can be added into existing post-operative management programs. The intervention is informed based off our published work and our own pilot data showing that gait speed after surgery does not recover and is linked to poor long-term outcomes. Focus Area of 2020 W81XWH-20-PRORP-CTRA Announcement Addressed: The proposed grant targets the funding announcements call to address retention to duty strategies through rehabilitation strategies that will allow patients to more quickly return to work/duty for common combat-related musculoskeletal injuries. To accomplish this, we will focus on individuals who have had a long bone fracture. Unfortunately, up to 50% of individuals report not being able to fully execute their jobs and over 65% of patients report not being able to return to prior activity levels. These low levels of full recovery have a direct negative impact on military readiness and contribute to less than 25% of military personnel returning to duty without profile restrictions. To address this understudied and served population we have developed a novel intervention that is informed by our own laboratories pilot studies and prior literature. The proposed intervention can be performed in clinics with minimal equipment. Types of Patients Helped and How It Will Help Them: In the short term, the results of the study will directly benefit patients who have had a long bone fracture. In addition, the study will provide insights that will benefit individuals with other types of fractures who are allowed to weight bear after surgery. The study will help patients and providers by providing a detailed assessment across multiple important domains of patient function of the effects of the intervention. We have designed the study to evaluate both the immediate effects of the intervention as well as the long-term (1-year follow-up) of the program. Potential Clinical Applications and Benefits: Potential clinical applications include an easy-to-implement therapy that can be included into standard of care of rehabilitation. In addition, despite years of advancement of the surgical care of patients with a long bone fracture, there is a paucity of evidence-based treatments for post-operative care. The speed HIIT intervention involves intensive monitored bouts of exercise and targets different pathways and systems as compared to standard gait training. The proposed intervention would undergo a rigorous assessment across multiple domains to better delineate who would best respond to this intervention and what types of improvements one might expect. Moreover, the results would contribute to a large multi-center follow-up study to define the benefits of this treatment across military and civilian sites by taking advantage of the investigator’s role in METRC. This will expedite the ability to move this initial pilot trial to a larger definitive study and ultimately affect current practice guidelines. Proposed Work Will Have Short- and Long-Term Impact on Patient Care and Restoration of Function: Less than 25% of individuals will return to full duty without profile restrictions following a lower-extremity trauma. The outcomes of the proposed project align with the goals for t
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 05, 2021
- Source ID
- W81XWH2110273
Entities
People
- Brian Noehren
Organizations
- United States Army
- University of Kentucky