Assessment of Functional Limitation and Associated Factors in Adults with Following Lower Limb Fractures, Gondar, Ethiopia in 2020: Prospective Cross-Sectional Study

Abstract

Background

Lower limb fractures account for approximately one-third of all fractures. Lower limb fracture complications are one of the major reasons for hospital stays and have high impact on rehabilitation services. Functional limitations with lower extremities fractures are related to decreased functional mobility, the need for long term use of assistive devices, lack of independence, and the long term need for assistive care. This study aimed to assess the functional limitation and identify the possible predictors among lower limb fracture patients by using the Lower Extremity Functional Scale (LEFS).

Methods

A prospective institutional-based cross-sectional study was conducted from July to October 30/2020, at University of Gondar, comprehensive specialized hospital. The data of 226 participants were collected through face-to-face interviews, patient record review and by physical examination with simple random sampling techniques. Binary logistic regression was used to identify predictors of functional limitation among lower limb fracture with SPSS 25. The strength of the association was present by adjusted odds ratios (OR).

Results

One hundred and eighty-two (n = 182 (80.5%): 95% CI (74.8 to 85.8) patients with following lower limb fracture have functional limitation. Level of education (AOR =5.50; 95% CI: 1.707–17.742), presence of hospitalized complication AOR=3.26; 95% CI (1.147–9.294), severity of pain AOR=3.19; 95% CI (1.399–7.259), duration of onset AOR=9.512; 95% CI (3.585–25.237), knee flexion limitation AOR=7.13; 95% CI (1.926–26.368) were the independent risk factors for functional limitation.

Conclusion

The magnitude of functional limitation in following lower limb fracture individual was considerably high in study setup. Level of education, presence of hospitalized complication, severity of pain, duration of onset, knee flexion limitation were the independent risk factors for functional limitation.

Keywords:

• fracture
• lower limb
• functional limitation
• range of motion
• pain

Abbreviations

AOR, adjusted odds ratio; ADL, activity of daily living; BMI, body mass index; CI, confidence interval; COR, crude odds ratio; LEFS, Lower Extremity Functional Scale; LMICs, lower and middle income countries; OPD, outpatient department; PF, plantar flexion; POP, plaster of Paris; ROM, range of motion; USA, United States of America; VAS, visual analogous scale; WHO, World Health Organization.

Data Sharing Statement and Availability

All data relevant to our findings are contained within the manuscript. Requests for further details on the dataset and queries concerning data sharing shall be arranged based on a reasonable request to correspondence author: [email protected]

Ethical Approval and Consent to Participate

This study was directed in accordance with the Declaration of Helsinki. To conduct the this study, the ethical approval was obtained from the Ethical Review Board of School of Medicine, College of Medicine and Health Sciences, University of Gondar (Ref. No. SOM/2035/2020), and voluntary informed written consent was taken from each study participant after being informed in detail about the objective, purpose, benefits and risk of the study. Personal identifiers were not noted during the data collection period to assure confidentiality.

Acknowledgments

Firstly, we would like to express our deepest gratitude to the University of Gondar for ethical approval and funding. Our gratitude and appreciation go to data collectors, supervisors, and study participants without their cooperation this study would have not been possible.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

All authors declare that they have no conflicts of interest in this work.

Additional information

Funding

This research didn’t receive any grant from any funding agency in the public, commercial, or not-for-profit sectors.