Association Between Intracompartmental Pressures in the Deep Posterior Compartment of the Leg and Conservative Treatment Outcome for Exercise-Related Leg Pain in Military Service Members.
Mats J L van der Wee, Sanne Vogels, Eric W P Bakker and 3 others
PMID 36545516WHAT IT FOUND
Deep posterior compartment pressure at intake did not predict return to duty after conservative treatment in military service members with exercise-related leg pain.
A lower self-rated leg function score was linked to poorer return-to-duty outcome.
Key findings
01A single post-exercise deep posterior compartment pressure value at intake was not associated with return to active duty after the conservative treatment program.
02Lower SANE score at intake was associated with not returning to active duty.
03No participant developed acute on chronic compartment syndrome during the treatment program.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was retrospective and used existing military medical records, so it cannot prove that pressure testing caused or failed to cause any outcome. It included only military service members with posteromedial exercise-related leg pain, so results may not apply to civilian patients, other leg pain locations, or other causes. The sample was small, with 83 patients analysed, so rare safety events could be missed. The primary outcome was return to active duty, a military-specific endpoint that may not match civilian functional goals. The exercise provocation tool used to measure pressure has not been formally validated, and the 35 mmHg cutoff is described as arbitrary. Patients with suspected superficial posterior compartment syndrome or popliteal artery entrapment were excluded, so the findings do not cover all posterior exertional leg pain. The conservative program was comprehensive and individualized, and the paper does not isolate the effect of any single component.
The easy way to misread this
Do not conclude that compartment pressure testing is unnecessary for every patient with exercise-related leg pain. This study only tested one post-exercise pressure value in military service members with posteromedial pain, and it excluded some posterior pain causes.