Association Between Intracompartmental Pressures in the Anterior Compartment of the Leg and Conservative Treatment Outcome for Exercise-Related Leg Pain in Military Service Members

Objective: To explore the relationship between a single the intracompartmental pressure (ICP) value in the anterior compartment of the leg 1 minute after provocative exercise and the outcome of a conservative treatment program in a cohort of military service members with chronic exercise-related leg pain.Design: Retrospective cohort study.Setting: Department of military sports medicine at a secondary care facility.Participants: In the years 2015 through 2019, the conservative treatment program was com-pleted by 231 service members with chronic exercise-related leg pain, of whom 108 patients with 200 affected legs met all inclusion criteria (N=108). Interventions: All patients completed a comprehensive conservative treatment program, con-sisting of 4-6 individual gait retraining sessions during a period of 6-12 weeks. In addition, patients received uniform homework assignments, emphasizing acquisition of the new running technique.Main Outcome Measures: The primary treatment outcome was return to active duty. The dura-tion of treatment, occurrence of acute on chronic compartment syndrome, and patient-reported outcome measures were considered secondary treatment outcomes. Potential risk factors for the primary treatment outcome were identified with a generalized logistic mixed model.Results: Return to active duty was possible for 74 (69%) patients, whereas 34 (31%) needed fur-ther treatment. The multivariable analysis showed that the absolute values of ICP in the anterior compartment were not associated with the treatment outcome (odds ratio, 1.01; P=.64). A lower Single Assessment Numeric Evaluation score at intake was negatively associated with the poten-tial to successfully return to active duty (odds ratio, 0.95; P=.01). No acute on chronic compart-ment syndromes were reported.Conclusions: A single postexercise ICP value in the anterior compartments of the lower leg of military service members with chronic exercise-related leg pain was not associated with the out-come of a secondary care conservative treatment program and can be safely postponed.(c) 2021 The Authors. Published by Elsevier Inc. on behalf of American Congress of Rehabilitation Medicine. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).