Background and Purpose. The LEFS was initially designed as a functional outcome measure for patients with lower-extremity orthopedic conditions.1 While the LEFS has been used for a broad spectrum of lower-extremity pathologies, there is a paucity of research that investigates the use of LEFS in patients who have had a first MTP joint implant. The purpose of this case report was to investigate the use of LEFS in a patient with a right first MTP HemiCAP(®) joint implant. Case Description. The patient was a 56 year-old male with bilateral pes planus. Conservative treatment for 9 years did not decrease symptoms associated with hallux rigidus, and the patient underwent surgery for a 1st MTP HemiCAP® arthrosurface implant.2 A physical therapy (PT) evaluation revealed impairments of right great toe range of motion, strength and balance. PT intervention included balance exercises, toe and ankle stretching and strengthening, gait training, and joint mobilizations of the first MTP with outcomes measured by the LEFS. Outcomes. The patient’s LEFS score was 60/80 at initial evaluation and 73/100 at discharge, showing a clinically important difference.1 He made significant gains in strength, range of motion and gait. His right single limb stance (SLS) balance improved from non-weight bearing to full weight bearing SLS for 45 seconds. He was able to return to his normal activities including golf. Discussion. This case report suggested that the use of the LEFS outcome measure was beneficial when assessing a patient who had a 1st MTP HemiCAP® arthrosurface implant. Future research should investigate the use of the LEFS in larger populations of patients with foot and ankle pathologies.
Brinckman, Courtney, "Use Of The Lower Extremity Functional Scale (LEFS) In A Patient After A First Metatarsophalangeal Joint Implant: A Case Report" (2015). Case Report Papers. 35.