,,Quality of life and patient satisfaction after the provision of an orthopedic knee scooter—a multicenter randomized controlled trial"

Autoren: Clas, Hannah; Ehrnthaller, Christian; Herrmann, Oliver; Schraeder, Dirk Theodor; Böcker, Wolfgang; Manz, Kirsi; Thaller, Peter

Quality of life and patient satisfaction after treatment with an orthopaedic knee roll

A randomised, controlled multicentre study

Full text article- https://www.aerzteblatt.de/archiv/240612/Lebensqualitaet-und-Patientenzufriedenheit-nach-Versorgung-mit-einem-orthopaedischen-Knieroller.

Annotation

background: After injuries and operations on the lower limbs, it is often necessary to relieve the affected limb of some or all of its weight. The incidence for this is around 200/100,000 inhabitants. Until now, forearm crutches have been used in Germany to enable the mobility of the affected patients. If there is a lack of strength or coordination, there is a risk of being confined to a wheelchair or of not providing relief for the affected limb, with possible resulting disadvantages and complications.

Method: The additional use of a novel orthopaedic rollator in the care of patients requiring complete or partial relief of the lower extremity was investigated in a multicentre, randomised clinical application study with 88 participants. The endpoints were improvement in quality of life (EQ-5D, SF-36) and increase in activities of daily living (subsequent registration: DRKS00032980).

Results: Patients in the group with orthopaedic knee roll (KR) reported more often a better general state of health (KR: SF-36 score 67, 95% confidence interval: [61; 73]; crutches [CR]: SF-36 score 59 [53; 64]), less anxiety and depression, and a higher degree of mobility and independence compared to patients with crutches. Study participants with CR also reported more frequently that they were able to cover a distance of 4 x 500 m in under 20 minutes (CR: n = 30; 63.8% [48.5; 77.3]; GS: n = 6; 14.6% [5.6; 29.2]).

Conclusion: The additional use of an orthopaedic scooter can improve medical care for patients in terms of mobility, independence and distance travelled. This probably also has the potential to reduce sick leave and absenteeism for some patients, thus lowering socioeconomic follow-up costs.

Scientific work

A comparsion of energy consumption between the use of a walking frame, crutches and a Stride-on rehabilitation scooter Nimesh Patel a,*, Timothy Battena, Andrew Robertona, Doyo Enki b, Guy Wansbrougha, James Davis a a Department of Trauma and Orthopaedics, Torbay Hospital,

A comparison of energy expenditure between the use of a walker, crutches and a knee scooter.

Authors: PanelNimesh Patel aTimothy Batten aAndrew Roberton aDoyo Enki bGuy Wansbrough aJames Davis u

Introduction

Energy expenditure during walking with a knee roller has not been previously studied.

Using a knee roller requires less energy compared to walking with crutches or a frame.

This can be used in post-operative patients to aid rehabilitation in patients with reduced upper body strength or low cardiovascular reserve.

Assessment

After foot and ankle surgery, patients may need to mobilise without weight bearing, which requires a walking aid such as crutches, a walking frame or a knee scooter to reduce the amount of work required. The energy expenditure of mobilisation with a knee scooter has not previously been studied and we aim to determine this.

Methods

Ten healthy volunteers (5 males: 5 females) aged 20-40 years were independently mobilised, then used each mobility device for 3 min at 1 km/h on a treadmill, with rest periods, while undergoing a cardiopulmonary exercise test (CPET). Oxygen consumption (VO 2 ), carbon dioxide excretion (VCO 2 ) , respiratory minute volume (MV), respiratory rate (RR) and heart rate (HR) were measured at baseline and after 3 min of walking without and with all 3 devices. The Wilcoxon signed-rank test was performed to calculate significance using non-parametric values with Bonferroni correction.

Results

Three-point crutch mobilisation showed significant increases in VO 2 (0.7 l), VCO 2 (0.7 l), MV (16.7 l/min), pulse (24.8 bpm) and RR (11.4 breaths/min) compared with walking ( p < 0.05). Mobilisation with a frame resulted in significant ( p < 0.05) increases compared to walking; VO 2 (0.7 l), VCO 2 (0.7 l), MV (18.3 l/min), pulse (35.9 bpm) and RR (11.7 breaths/min). Knee roller tests showed no significant increase compared to walking in terms of VO 2 (0.1 L; p = 0.959), VCO 2 (0.2 l; p = 0.332), pulse (10.1 bpm; p = 0.575) and RR (4.7 breaths/min; p = 0.633). MV was significantly higher compared to walking (4.3 l/min; p < 0.05).

Discussion

This justifies its use as part of routine practice to support early mobilisation of patients requiring limited weight bearing or single leg weight bearing, particularly in patients with reduced cardiopulmonary reserve, as it is less physiologically demanding and does not rely on upper body strength.