Knee scooter related injuries and satisfaction in patients following foot and ankle surgery

Workman, Matthew; Ettehadi, Hossein; Saragas, Nikiforos Pandelis; Ferrao, Paulo N. F.

doi:10.1016/j.fas.2021.12.003

Cited by 6 publications

(8 citation statements)

References 8 publications

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“…Moreover, obstacles such as stairs cannot be overcome without assistance. 5 , 12 , 16 , 26 An alternative that combines unloading without crutches and high mobility is an HFSO ( Figure 1 ) that promises higher patient satisfaction and comfort. 12 , 17 The mode of action of such an orthosis is based on the orthosis being applied with the knee bent at 90 degrees on the affected operated side.…”

Section: Introductionmentioning

confidence: 99%

Functional, Spiroergometric, and Subjective Comparisons Between Forearm Crutches and Hands-Free Single Crutches in a Crossover Study

Yao,

Meyer-Kobbe,

Ettinger

et al. 2023

Foot & Ankle Orthopaedics

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Background: Following below-knee surgery, the optimal medical mobility device remains controversial as adequate nonweightbearing of the operated extremity is critical to ensure successful healing. The use of forearm crutches (FACs) is well established but requires using both upper extremities. The hands-free single orthosis (HFSO) is an alternative that spares the upper extremities. This pilot study compared functional, spiroergometric, and subjective parameters between HFSO and FAC. Methods: Ten healthy (5 females, 5 males) participants were asked to use HFSOs and FACs in a randomized order. Five functional tests were performed: climbing stairs (CS), an L-shaped indoor course (IC), an outdoor course (OC), a 10-meter walk test (10MWT), and a 6-minute walk test (6MWT). Tripping events were counted while performing IC, OC, and 6MWT. Spiroergometric measurements consisted of a 2-step treadmill test with speeds of 1.5 and 2 km/h, each for 3 minutes. Lastly, a VAS questionnaire was completed to collect data regarding comfort, safety, pain, and recommendations. Results: Significant differences between both aids were observed in CS and IC (HFSO: 29.3 seconds; FAC: 26.1 seconds, P < .03; and HFSO: 33.2 seconds, FAC: 18 seconds, P < .001, respectively). The other functional tests showed no significant differences. The trip events were not significantly different between the use of the 2 aids. Spiroergometric tests showed significant differences regarding heart rate (HFSO: 131.1 bpm at 1.5 km/h and 131 bpm at 2 km/h; FAC: 148.1 bpm at 1.5 km/h and 161.8 bpm at 2 km/h) and oxygen consumption (HFSO: 15.4 mL/min/kg at 1.5 km/h and 16 mL/min/kg at 2 km/h; FAC: 18.3 mL/min/kg at 1.5 km/h and 21.9 mL/min/kg at 2 km/h) at both speeds (all P < .01). In addition, significantly different ratings regarding the items comfort, pain, and recommendation were recorded. Both aids were equally rated for safety. Conclusion: HFSOs may be an alternative to FACs, especially in activities that require physical stamina. Further prospective studies in patients with below-knee surgical intervention concerning everyday clinical use would be interesting. Level of Evidence: Level IV pilot-study.

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Section: Introductionmentioning

confidence: 99%

Functional, Spiroergometric, and Subjective Comparisons Between Forearm Crutches and Hands-Free Single Crutches in a Crossover Study

Yao,

Meyer-Kobbe,

Ettinger

et al. 2023

Foot & Ankle Orthopaedics

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Section: Introductionmentioning

confidence: 99%

“…MKS is generally associated with less energy expenditure during movement 18 ; however, the hands are still required to steer the device, and the surface used while maneuvering can limit utility or lead to complications including falls. 30 Hands-free crutch (HFC) is a relatively new mobility device that can be used during the musculoskeletal unloading period to increase physical activity and the use of the upper extremity limbs for activities of daily living. 2,13 In 2007, Rambani et al 19 conducted a randomized controlled trial on HFC in patients with injuries that prevented them from using an AC crutch.…”

Section: Introductionmentioning

confidence: 99%

Energy Expenditure and Substrate Utilization with Hands-Free Crutches Compared to Conventional Lower-Extremity Injury Mobility Devices

Hackney

Bradley

Roehl

et al. 2022

Foot & Ankle Orthopaedics

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Background: A Hands-Free crutch (HFC) is a relatively new device that can be used during the nonweightbearing period to increase mobility. The primary aim of this investigation was to examine aerobic oxygen consumption (V.o2) and substrate utilization with HFC compared to conventional ambulation devices as well as normal ambulation. A secondary purpose was to quantify perceived exertion, pain, and performance during each ambulation condition. Methods: Forty participants completed 4 separate 10-minute ambulation conditions around a rectangular course. The order of the ambulation conditions was randomized and consisted of (1) walking, (2) medical knee scooter (MKS), (3) HFC, and (4) axillary crutch (AC). Indirect calorimetry was used to determine V.o2 and the respiratory exchange ratio (RER), an indicator of substrate utilization. Perceived exertion and pain were also assessed using questionnaires. Results: All mobility devices significantly elevated V.o2 (+35%) compared to walking (13.14 ± 1.70 mL/kg/min; P < .001). AC had significantly greater V.o2 requirements (20.26 ± 2.62 mL/kg/min) compared to both the MKS (15.28 ± 2.29 mL/kg/min; P < .001) and HFC (15.88 ± 2.03 mL/kg/min; P < .001). There was no difference in average V.o2 between MKS and HFC ( P = .368). Compared to walking (0.78 ± 0.43), RER was significantly elevated in MKS (0.81 ± 0.05, P < .001) and AC (0.84 ± 0.06, P < .001), but not in HFC (0.79 ± 0.04, P = .350). RPE and pain were elevated in all ambulatory conditions (all P values <.001). Pain was significantly greater in AC compared with MKS ( P < .001) and HFC ( P < .001). Conclusion: HFC and MKS share similar V.o2 requirements over a 10-minute ambulation interval and are below those needed in AC. Substrate utilization in HFC was similar to regular walking with a greater reliance on lipid utilization for energy as evidenced by a lower RER. Exertion and pain scores were the most tolerable in HFC and MKS. Level of Evidence: Level II, prospective comparative study.

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“…There was no correlation between falls and patient comorbidities. 53 In addition to falls, another major complication cited is the development of deep vein thrombosis (DVT) due to prolonged knee flexion. This is a concern among those providers who prescribe the RKS as there are no formal studies that quantify the DVT rates in this population.…”

Section: Rolling Knee Scootermentioning

confidence: 99%

“…In another survey to assess patient complications with the RKS, Workman et al 53 found that 25 of 101 patients (24.7%) experienced some form of a fall, with 5 patients seeking medical attention due to injury (4.9%). The study cohort had an average age of 54 years, with an average body mass index of 28.5.…”

Section: Novel Leadsmentioning

confidence: 99%

Lower Extremity Assistive Devices (LEADs): A Contemporary Literature Review

Hegeman,

Huh

2023

Foot Ankle Int.

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Lower extremity ambulatory assistive devices (LEADs) are important augments that provide mobility and stability when weightbearing is restricted in the setting of injury, surgery, or balance disorders. In order to optimize patient safety and function when prescribing these devices, it is essential for the orthopaedic surgeon to have a firm understanding of their specific indications, proper fitting, energy demand, biomechanical advantages, and potential complications. Comprehension of normal gait cadence, identification of the functional deficit present and knowledge of available options will assist in safely prescribing the proper device. Over the last decade, newer alternatives to traditional LEADs (canes, crutches, walkers) have become available, including the rolling knee scooter and hands-free single crutch. These have been developed to improve mobility and independence; however, it is necessary to appreciate their limitations when prescribing them to patients. This review will provide an update on normal and pathologic gait biomechanics as well as the most common types of LEADs currently available to the orthopaedic surgeon, their indications, important considerations, proper fitting, associated energy expenditure, and complications.

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Knee scooter related injuries and satisfaction in patients following foot and ankle surgery

Cited by 6 publications

References 8 publications

Functional, Spiroergometric, and Subjective Comparisons Between Forearm Crutches and Hands-Free Single Crutches in a Crossover Study

Functional, Spiroergometric, and Subjective Comparisons Between Forearm Crutches and Hands-Free Single Crutches in a Crossover Study

Energy Expenditure and Substrate Utilization with Hands-Free Crutches Compared to Conventional Lower-Extremity Injury Mobility Devices

Lower Extremity Assistive Devices (LEADs): A Contemporary Literature Review

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