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Question: What predicts short- and medium-term activity limitation in people after ankle fracture? Design: Inception cohort observational study. Participants: Adults with ankle fracture recruited within days following cast removal from physiotherapy departments of teaching hospitals in Sydney, Australia. Outcome measures: The predictive value of variables that were injury-related (fracture management, fracture severity, angle of the ankle during cast immobilisation, and time from cast removal to baseline) and performance-related (activity limitation, pain, mobility, and dorsiflexion range of motion measured soon after cast removal) were examined in one dataset (n = 150) using univariate linear regression. Significant variables (p ≤ 0.20) were further examined with a multivariate linear model. A clinical prediction rule was derived then validated using data from an independent dataset (n = 94). Results: Fracture management, fracture severity, baseline activity limitation, pain, mobility, and dorsiflexion had significant but weak univariate associations with activity limitation. Only pain and dorsiflexion range of motion contributed independently to the clinical prediction rule. When applied to the validation data, the rule explained 12% of the short-term and 9% of the medium-term variance in activity limitation. Conclusion: Performance-related variables were stronger predictors than injury-related variables. A clinical prediction rule consisting of pain and dorsiflexion range of motion explained a small amount of the variance in short- and medium-term activity limitation, suggesting that it may be appropriate to identify people with high levels of pain and restricted dorsiflexion after ankle fracture and target intervention accordingly. [ABSTRACT FROM AUTHOR]

The article discusses research on the prognosis for an inception cohort of patients with chronic low back pain. The study population was a subcohort of an inception cohort of 973 consecutive patients with acute low back pain from primary care clinics in Sydney, New South Wales. Variables measured after nine to 12 months follow-up include pain intensity, pain related disability and work status based on the Kaplan-Meier survival probability estimates. Presented in detail are the 25 centile survival times and generalisability to other populations.