Clin Orthop Surg.  2018 Dec;10(4):491-499. 10.4055/cios.2018.10.4.491.

Analysis of Postural Stability and Daily Energy Expenditure to Manage Tumor Patients' Functional Expectation

• Caliskan E
• Karadag Saygi E
• Gencer ZK
• Kurtel H
• Erol B

• KMID: 2426536
• DOI: http://doi.org/10.4055/cios.2018.10.4.491

Abstract

BACKGROUND
Advances in surgical techniques, implant technology, radiotherapy, and chemotherapy have increased the recovery chances of patients with bone sarcomas. Accordingly, patients' expectations on life quality have also increased, highlighting the importance of objective evaluation of the functional results of reconstruction.
METHODS
Thirteen patients with distal femoral endoprosthesis, who had been followed for an average of 2.9 years were evaluated. Postural stability, daily energy expenditure, muscle power, and range of motion were the four parameters analyzed in this study. The Musculoskeletal Tumor Society (MSTS) score and Toronto Extremity Salvage Score (TESS) were used to assess postoperative function and examine correlations with other parameters.
RESULTS
Patients had sedentary activities in 84% of their daily lives. They exhibited a slower speed in the walk across test and a higher sway velocity in the sit-to-stand test (p = 0.005). MSTS scores were significantly correlated with the daily energy expenditure and walking speed.
CONCLUSIONS
Objective functional results acquired from various clinics will provide significant data to compare reconstruction techniques, rehabilitation protocols, and surgical techniques. In this way, it will be possible to satisfy the expectations of patients that increase in relation to enhanced recovery.

Keyword

Endoprostheses; Femur; Range of motion; Energy expenditure

MeSH Terms

Drug Therapy
Energy Metabolism*
Extremities
Femur
Humans
Quality of Life
Radiotherapy
Range of Motion, Articular
Rehabilitation
Sarcoma
Walking

Figure

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  Fig. 1 Preoperative radiograph (A) and 2-year postoperative anteroposterior (B) and lateral (C) radiographs of a 17-year-old patient.

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  Fig. 2 Step-up-and-over test on a NeuroCom device. (A) The subject steps onto a stool on one foot. (B) The other foot is put down on the strength plate. (C) The foot on the stool is moved next to the other foot on the strength plate.

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  Fig. 3 Computerizing Actical data. (A) Graphical and numerical expression of daily energy expenditure and relationship between time consumed and activity density. (B) In the middle of the 1st day, the device is attached to the patient, and in the middle of the 4th day, the device is retrieved to determine activities and daily energy consumption. SED: sedentary activity, MOD: moderate activity, VIG: vigorous activity.

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