Identifying prognostic factors for conservative treatment outcomes in servicemen with chronic exertional compartment syndrome treated at a rehabilitation center

Mariëtte Z. Meulekamp; Peter van der Wurff; Alfred van der Meer; Cees Lucas

doi:10.1186/s40779-017-0145-2

Your Location：

Home >

Browse articles >

Identifying prognostic factors for conservative treatment outcomes in servicemen with chronic exertional compartment syndrome treated at a rehabilitation center

RESEARCH | Updated：2026-03-12

- Identifying prognostic factors for conservative treatment outcomes in servicemen with chronic exertional compartment syndrome treated at a rehabilitation center
- Identifying prognostic factors for conservative treatment outcomes in servicemen with chronic exertional compartment syndrome treated at a rehabilitation center
- MMR 2018年5卷第3期页码：199-206
- Affiliations：
  
  1.Research and Development, Military Rehabilitation Centre, Aardenburg, Doorn, the Netherlands
  2.Department of Physiotherapy, HU University of Applied Sciences, Utrecht, the Netherlands
  3.Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
- Author bio：
  
  *: m.meulekamp@mrcdoorn.nl
- Funds：
- DOI：10.1186/s40779-017-0145-2
  中图分类号：
- 纸质出版：2018-09
- Accepted：
Scan QR Code
Identifying prognostic factors for conservative treatment outcomes in servicemen with chronic exertional compartment syndrome treated at a rehabilitation center[J]. MMR, 2018,5(3):199-206.

Meulekamp et al.: Identifying prognostic factors for conservative treatment outcomes in servicemen with chronic exertional compartment syndrome treated at a rehabilitation center. Mil Med Res, 2017, 4: 36
Identifying prognostic factors for conservative treatment outcomes in servicemen with chronic exertional compartment syndrome treated at a rehabilitation center[J]. MMR, 2018,5(3):199-206. DOI： 10.1186/s40779-017-0145-2.

Meulekamp et al.: Identifying prognostic factors for conservative treatment outcomes in servicemen with chronic exertional compartment syndrome treated at a rehabilitation center. Mil Med Res, 2017, 4: 36 DOI： 10.1186/s40779-017-0145-2.

摘要

Abstract

Background:

Chronic exertional compartment syndrome (CECS) is a condition of pain induced by exercise

and it is characterized by muscle swelling and impaired muscle function in the lower leg. Given the diversity in the diagnosis and treatment of CECS

it is desirable to determine variables pertaining to prognosis and recovery. The purpose of this study is to identify prognostic factors for conservative treatment outcomes in servicemen with CECS who were treated at a Military Rehabilitation Center.

Methods:

Patients from all military services were referred from the special unit for lower leg pain at the Central Military Hospital

Utrecht

the Netherlands. Descriptive analysis was used to report the characteristics of the participants and their baseline measurements. Group differences were analyzed using a Student’s

-test or Mann-Whitney

test

according to the normality of the data distribution. Differences between the pre- and post-intervention outcomes were evaluated using the Wilcoxon signed rank test. To evaluate the magnitude of prognostic factors

a univariate logistic regression analysis was performed. The prognostic factors included age

body mass index

body fat percentage

self-efficacy beliefs

foot malalignment

intramuscular pressure

other comorbidities

protein and creatine use

smoking

alcohol use

complaint duration

physical demands

and duration of military service.

Results:

After the rehabilitation period

we observed 25 patients with a successful outcome

which was defined as a reduction in pain (≥2 points) during the capacity test measured using a verbal rating scale and 20 patients with an unsuccessful outcome. Factors demonstrating a limited increased odds ratio for an unsuccessful outcome included smoking

alcohol use

intramuscular pressure

a complaint duration of more than 6 months

and physical demands of service. However

these factors did not reach significance.

Conclusion:

This study did not identify any prognostic factors that predict the outcome of a rehabilitation program for CECS. A larger sample using an identical design might provide further evidence regarding prognostic factors

which would facilitate development of a model that predicts the outcomes of a rehabilitation program for CECS.

关键词

Keywords

references

Waterman BR , Liu J , Newcomb R , Schoenfeld AJ , Orr JD , Belmont PJ Jr . Risk factors for chronic exertional compartment syndrome in a physically active military population . Am J Sports Med . 2013 ; 41 ( 11 ): 2545 - 9 .

Orlin JR , Haabesland Lied I , Stranden E , Underthun Irgens H , Andersen JR . Prevalence of chronic compartments syndrome of the legs: implications for clinical diagnostic criteria and therapy . Scan J Pain . 2016 ; 12 : 7 - 13 .

Ringler MD , Litwiller DV , Felmlee JP , Shahid KR , Finnoff JT , Carter RE , et al . MRI accurately detects chronic exertional compartment syndrome: a validation study . Skelet Radiol . 2013 ; 42 ( 3 ): 385 - 92 .

Brennan FH Jr , Kane SF . Diagnosis, treatment options, and rehabilitation of chronic lower leg exertional compartment syndrome . Curr Sports Med Rep . 2003 ; 2 ( 5 ): 247 - 50 .

Howard JL , Mohtadi NG , Wiley JP . Evaluation of outcomes in patients following surgical treatment of chronic exertional compartment syndrome in the leg . Clin J Sport Med . 2000 ; 10 ( 3 ): 176 - 84 .

Winkes MB , Hoogeveen AR , Scheltinga MR . Is surgery effective for deep posterior compartment syndrome of the leg? A systematic review. Br J Sports Med . 2014 ; 48 ( 22 ): 1592 - 8 .

Aweid O , Del Buono A , Malliaras P , Iqbal H , Morrissey D , Maffulli N , et al . Systematic review and recommendations for intracompartmental pressure monitoring in diagnosing chronic exertional compartment syndrome of the leg . Clin J Sport Med . 2012 ; 22 ( 4 ): 356 - 70 .

Roberts A , Franklyn-Miller A . The validity of the diagnostic criteria used in chronic exertional compartment syndrome: a systematic review . Scand J Med Sci Sports . 2012 ; 22 ( 5 ): 585 - 95 .

Roscoe D , Roberts AJ , Hulse D . Intramuscular compartment pressure measurement in chronic exertional compartment syndrome: new and improved diagnostic criteria . Am J Sports Med . 2015 ; 43 ( 2 ): 392 - 8 .

Cruz AI Jr , Laidlaw MS . Invasive compartment pressure testing for chronic exertional compartment syndrome: a survey of clinical practice among military orthopedic surgeons . Am J Orthop (Belle Mead, NJ) . 2015 ; 44 ( 10 ): E384 - 9 .

Orlin JR , Oen J , Andersen JR . Changes in leg pain after bilateral fasciotomy to treat chronic compartment syndrome: a case series study . J Orthop Surg Res . 2013 ; 8 : 6 .

Reinking MF , Austin TM , Hayes AM . Exercise-related leg pain in collegiate cross-country athletes: extrinsic and intrinsic risk factors . J Orthop Sports Phys Ther . 2007 ; 37 ( 11 ): 670 - 8 .

Dunn JC , Waterman BR . Chronic exertional compartment syndrome of the leg in the military . Clin Sports Med . 2014 ; 33 ( 4 ): 693 - 705 .

Rajasekaran S , Hall MM . Nonoperative management of chronic exertional compartment syndrome: a systematic review . Curr Sports Med Rep . 2016 ; 15 ( 3 ): 191 - 8 .

Blackman PG , Simmons LR , Crossley KM . Treatment of chronic exertional anterior compartment syndrome with massage: a pilot study . Clin J Sport Med . 1998 ; 8 ( 1 ): 14 - 7 .

Diebal AR , Gregory R , Alitz C , Gerber JP . Effects of forefoot running on chronic exertional compartment syndrome: a case series . Int J Sports Phys Ther . 2011 ; 6 ( 4 ): 312 - 21 .

Diebal AR , Gregory R , Alitz C , Gerber JP . Forefoot running improves pain and disability associated with chronic exertional compartment syndrome . Am J Sports Med . 2012 ; 40 ( 5 ): 1060 - 7 .

Helmhout PH , Diebal AR , van der Kaaden L , Harts CC , Beutler A , Zimmermann WO . The effectiveness of a 6-week intervention program aimed at modifying running style in patients with chronic exertional compartment syndrome: results from a series of case studies . Orthop J Sports Med . 2015 ; 3 ( 3 ): 2325967115575691 .

Packer JD , Day MS , Nguyen JT , Hobart SJ , Hannafin JA , Metzl JD . Functional outcomes and patient satisfaction after fasciotomy for chronic exertional compartment syndrome . Am J Sports Med . 2013 ; 41 ( 2 ): 430 - 6 .

Breen DT , Foster J , Falvey E , Franklyn-Miller A . Gait re-training to alleviate the symptoms of anterior exertional lower leg pain: a case series . Int J Sports Phys Ther . 2015 ; 10 ( 1 ): 85 - 94 .

Campano D , Robaina JA , Kusnezov N , Dunn JC , Waterman BR . Surgical management for chronic exertional compartment syndrome of the leg: a systematic review of the literature . Arthroscopy . 2016 ; 32 ( 7 ): 1478 - 86 .

Winkes MB , Hoogeveen AR , Houterman S , Giesberts A , Wijn PF , Scheltinga MR . Compartment pressure curves predict surgical outcome in chronic deep posterior compartment syndrome . Am J Sports Med . 2012 ; 40 ( 8 ): 1899 - 905 .

Meulekamp MZ , Sauter W , Buitenhuis M , Mert A , van der Wurff P . Shortterm results of a rehabilitation program for service members with lower leg pain and the evaluation of patient characteristics . Mil Med . 2016 ; 181 ( 9 ): 1081 - 7 .

Zimmermann WO , Helmhout PH , Beutler A . Prevention and treatment of exercise related leg pain in young soldiers; a review of the literature and current practice in the Dutch armed forces . J R Army Med Corps . 2017 ; 163 ( 2 ): 94 - 103 .

WHO . Mean body mass index (BMI) . http://apps.who.int/bmi/index.jsp?introPage=intro_3.html http://apps.who.int/bmi/index.jsp?introPage=intro_3.html . Accessed 15 Oct 2017 .

Durnin JV , Womersley J . Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years . Br J Nutr . 1974 ; 32 ( 1 ): 77 - 97 .

der Maas LCC v , HCW d V , Köke A , Bosscher RJ , Peters ML . Psychometric properties of the pain self-efficacy questionnaire (PSQE): validation, prediction, and discrimination quality of the Dutch version . Eur J Psych Ass . 2012 ; 28 ( 1 ): 68 - 75 .

Redmond AC , Crosbie J , Ouvrier RA . Development and validation of a novel rating system for scoring standing foot posture: the foot posture index . Clin Biomech (Bristol, Avon) . 2006 ; 21 ( 1 ): 89 - 98 .

Hjermstad MJ , Fayers PM , Haugen DF , Caraceni A , Hanks GW , Loge JH , et al . Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: a systematic literature review . J Pain Symptom Manag . 2011 ; 41 ( 6 ): 1073 - 93 .

Von Korff M , Jensen MP , Karoly P . Assessing global pain severity by selfreport in clinical and health services research . Spine (Phila Pa 1976) . 2000 ; 25 ( 24 ): 3140 - 51 .

Abbott JH , Schmitt JS . The patient-specific functional scale was valid for group-level change comparisons and between-group discrimination . J Clin Epidemiol . 2014 ; 67 ( 6 ): 681 - 8 .

Waterman BR , Laughlin M , Kilcoyne K , Cameron KL , Owens BD . Surgical treatment of chronic exertional compartment syndrome of the leg: failure rates and postoperative disability in an active patient population . J Bone Joint Surg Am . 2013 ; 95 ( 7 ): 592 - 6 .

浏览量

Downloads

CSCD

文章被引用时，请邮件提醒。

Submit

工具集

关联资源

Fostering hope and recovery: enhancing psychological resources in military personnel with post-traumatic stress disorder

Recent applications of EEG-based brain-computer-interface in the medical field

Effects and mechanism of platelet-rich plasma on military drill injury: A review