Functional assessment and influencing factors after staged functional training in patients with ankle fractures

Table 1 Functional evaluation results of subjects

Group	Plantarflexion angle			Dorsal extension angle			AOFAS Ankle-Hindfoot Score (points)
	Before intervention	1 month after intervention	3 months after intervention	Before intervention	1 month after intervention	3 months after intervention	Before intervention	1 month after intervention	3 months after intervention
Subject	11.95 ± 2.07	24.41 ± 2.67a	33.91 ± 3.11b	6.53 ± 1.47	11.83 ± 1.92a	15.73 ± 3.26b	53.11 ± 6.01	64.74 ± 6.08a	81.84 ± 10.16b
t value	0.951	8.538	8.975	1.578	7.329	9.772	1.192	4.381	3.839
P value	0.343	< 0.001	< 0.001	0.117	< 0.001	< 0.001	0.235	< 0.001	< 0.001

^aP < 0.05 compared with the same group before intervention.

^bP < 0.05.

AOFAS: American Orthopedic Foot and Ankle Score.

Table 2 Factors influencing limb function after staged functional training

Independent variables	Grouping	Excellent functional group (n = 111)	General functional group (n = 39)	χ2	P value
Sex	Male	69	19	2.151	0.142
	Female	42	20
Age (years)		46.58 ± 4.35	46.77 ± 4.28	0.236	0.814
Monthly household income (RMB)	≤ 5000	34	19	4.132	0.042
	> 5001	77	20
Educational level	High school and below	42	22	4.070	0.044
	Junior college or above	69	17
Comorbid diabetes	Yes	81	21	4.852	0.028
	No	30	18
Lauge–Hansen classification	Pronation-abduction	31	9	2.269	0.518
	Pronation-external rotation	26	13
	Supination-adduction	29	7
	Supination-external rotation type	25	10
Start time of postoperative exercise (hour)	48-72	69	17	4.070	0.044
	> 72	42	22
BMI (kg/m2)		24.65 ± 3.68	24.74 ± 3.72	0.131	0.896
Lower tibiofibular fixation	Yes	83	22	4.635	0.031
	No	28	17
Functional exercise compliance scale (points)	Male	49.65 ± 9.46	42.36 ± 8.79	4.214	< 0.01
SSRS (points)	Female	30.64 ± 3.45	24.36 ± 2.46	10.461	< 0.01
BK (μg/L)		6.41 ± 1.32	8.75 ± 1.47	9.243	< 0.01
PGE2 (ρg/mL)	≤ 5000	170.66 ± 19.62	214.14 ± 18.70	12.048	< 0.01
5-HT (ng/L)	> 5001	97.84 ± 18.75	121.44 ± 16.38	6.977	< 0.01

Data are expressed as mean ± SD or number. Lauge-Hansen classification: Ankle fracture classification; BMI: Body mass index; SSRS: Social Support Rating Scale; BK: Bradykinin; PGE2: Prostaglandin E2; 5-HT: 5-hydroxytryptamine.

Table 3 Assignment of variables

Variables		Assignment method
Dependent variable	Functional status	General function group = 1, excellent function group = 0
Independent variables	Monthly household income	≤ RMB 5000 = 1, > RMB 5001 = 0
	Educational level	High school and below = 1, junior college or above = 0
	Comorbid diabetes	Yes = 1, No = 0
	Start time of postoperative exercise	48-72 hours = 1, > 72 hours = 0
	Lower tibiofibular fixation	No = 1, yes = 0
	Functional exercise compliance scale	Input as original value
	SSRS	Input as original value
	BK	Input as original value
	PGE2	Input as original value
	5-HT	Input as original value

SSRS: Social Support Rating Scale; BK: Bradykinin; PGE2: Prostaglandin E2; 5-HT: 5-hydroxytryptamine.

Table 4 Multivariate analysis of factors influencing function after staged functional training following ankle fracture surgery

Independent variables	β	SE	Wald χ2	P value	OR	95%CI
						Lower limit	Upper limit
Functional Exercise Compliance Scale for orthopedic patients	-4.941	-6.914	-2.967	1.001	-0.247	-4.937	< 0.001
SSRS	-9.664	-12.377	-6.951	1.375	-0.341	-7.026	< 0.001
BK	-9.664	-12.377	-6.951	1.375	-0.341	-7.026	< 0.001
PGE2	-2.995	-5.466	-0.525	1.252	-0.112	-2.392	0.018
5-HT	-11.507	-15.358	-7.655	1.953	-0.289	-5.892	< 0.001

SSRS: Social Support Rating Scale; BK: Bradykinin; PGE2: Prostaglandin E2; 5-HT: 5-hydroxytryptamine. The indicators in this table are only the relevant influencing factors with P < 0.05).