Does Resilience Correlate with Patient-Reported Outcomes Following Isolated Gastrocnemius Recession

Abstract

Background: Patients' characteristics, both physical and mental, are proven to have relationships to patient-reported outcomes following orthopaedic surgeries. This study aims to elucidate the impact of resilience, using the Brief Resilience Scale, on patient-reported outcomes following isolated gastrocnemius recession for patients with plantar fasciitis or Achilles tendinopathy with secondary exploratory analysis on factors influencing these outcomes.

Methods: Patients were selected utilizing the current procedural terminology code 27687 between 2013-2020. The electronic medical record was reviewed for basic demographics. Patients were contacted for patient-reported outcome measurement information system (PROMIS) scores, foot function index (FFI) scores, and brief resilience scale survey questionnaires. Pearson correlations were used to assess the association of FFI and PROMIS domains. A linear regression model was constructed to evaluate the independent effect of resilience on each FFI and PROMIS outcome instrument. A significance threshold of P < 0.05 was used to determine significance in the regression model.

Results: Increased resiliency showed a significant correlation with increased PROMIS physical function (r = 0.46, p<0.0001), decreased PROMIS pain interference (r = -0.043, p < 0.0001), and decreased PROMIS depression (r= -0.04, p < 0.0001). Increased resiliency showed a significant correlation with decreased FFI activity limitation (r= -0.047, p < 0.0001), decreased FFI disability (r = -0.53, p < 0.0001), decreased FFI pain (r = -0.36, p < 0.0001), and decreased FFI total (r= -0.52, p < 0.0001).

Conclusion: This study demonstrates the positive impact resilience has on patient-reported outcomes following isolated gastrocnemius recession for patients with a clinical diagnosis of either Achilles tendinopathy or plantar fasciitis. We were able to show a moderate correlation between higher resiliency and improved PROMIS and FFI scores for all domains. Optimizing resiliency preoperatively may help to optimize an individual's own surgical outcomes and aid physicians in managing patient expectations following surgery. Level of Evidence: IV.

Keywords: PROMIS; gastrocnemius; patient-reported outcomese; resilience.