Publication Date

2015-07-27

Availability

Open access

Embargo Period

2015-07-27

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PHD)

Department

Physical Therapy (Medicine)

Date of Defense

2015-04-01

First Committee Member

Neva Kirk-Sanchez

Second Committee Member

Michele A. Raya

Third Committee Member

Kathryn E. Roach

Fourth Committee Member

Bryson Lesniak

Abstract

Meniscus tears are the second most common orthopedic injury of the knee with an incidence of 12% to 14% and a prevalence of 61 cases per 100,000 persons.2,3 Physical therapy (PT) is a standard of care for these patients post-meniscectomy, but research is conflicting on the benefits and the most appropriate outcome measures to use when assessing activity levels in these patients. The main purpose of this dissertation was to explore 5 performance-based outcome measure (single-limb single hop test for distance (SLHT), single-limb crossover hop test for distance (CHT), Edgren side step test (ESST), Illinois agility test (IAT), and stair measure test (SMT)), 3 of which were recommended by the clinical practice guidelines (CPGs) for meniscal lesions, in order to provide information on the reliability and validity of these measures for patients after meniscectomy. A secondary purpose of this dissertation was to identify the differences in outcomes between patients with degenerative meniscus tears and non-degenerative meniscus tear by investigating recovery post-arthroscopic partial meniscectomy. A convenience sample of patients who underwent an arthroscopic partial meniscectomy were recruited from the University of Miami Hospital sports medicine clinic. Subjects were categorized into one of two groups based on whether their meniscus tear was degenerative or not. Subjects were treated by one of five physical therapists. The rehabilitation protocol consisted of 45 minutes to 1 hour of PT 2-3x/week for a total of 8 weeks. A general protocol was followed for the first 4 weeks of rehabilitation and an individualized protocol was incorporated into the final 4 weeks of rehabilitation. Assessments were performed at initial PT evaluation (week 0), at four weeks post-meniscectomy (week 4), and 8 weeks post-meniscectomy (week 8). Comparisons were made in terms of impairments, activity limitations, and participation restrictions using both patient-reported outcomes (IKDC, Tegner) and performance-based outcomes. This work provides information on the reliability and validity of 5 activity level performance-based outcome measures for patients after arthroscopic partial meniscectomy. Additionally, it discusses the importance of making sure these outcome measures are appropriate to the population of patients being examined. Because there are two different subpopulations of patients with meniscus tears, patients with degenerative meniscus tear and patients with non-degenerative meniscus tears, different activity level outcome measures should be considered when studying and treating these different types of patients with meniscus tears. Finally, this work demonstrates similar patterns of recovery in patients with degenerative and non-degenerative meniscus tears. Both groups nearly recover to their pre-morbid level of activity after 8-weeks of PT.

Keywords

knee; meniscus; physical therapy; rehabilitation; outcomes; performance-based measures

Share

COinS