Clinical research on staged functional exercise for donor site limb rehabilitation after vascularized fibular flap surgery in oral cancer patients

To investigate the clinical effects of staged functional exercise on donor site limb rehabilitation after VFFF surgery in oral cancer patients. A retrospective analysis was conducted on 78 oral cancer patients who underwent VFFF surgery at the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from November 2022 to November 2023. Patients were divided into an observation group receiving staged functional exercise (n=39) and a control group receiving routine care (n=39). The great toe muscle strength, ankle range of motion, AOFAS score, Tinetti balance and gait score, and SF-36 score were analyzed preoperatively and at 1 week, 2 weeks, 1 month, and 3 months postoperatively. There were no statistically significant differences in baseline characteristics between the two groups ( P >0.05). GEE analysis showed significant time effects, group effects, and interaction effects for great toe muscle strength (all P <0.05). Repeated measures ANOVA showed significant time effects, group effects, and interaction effects for ankle range of motion, AOFAS-ankle and hindfoot function, Tinetti balance and gait, and SF-36 (all P <0.05); and significant time effects and group effects for AOFAS-hallux function (both P <0.05). Mann-Whitney U test showed that great toe muscle strength in the observation group was significantly better than the control group at 1 and 3 months postoperatively (all P <0.05). T-tests showed that: AOFAS-hallux function was significantly better in the observation group at 2 weeks and 1 month postoperatively; ankle range of motion (plantar flexion, dorsiflexion, inversion, and eversion) was significantly better in the observation group at 2 weeks, 1 month, and 3 months postoperatively; AOFAS-ankle and hindfoot function and Tinetti balance and gait were significantly better in the observation group at 2 weeks, 1 month, and 3 months postoperatively (all P <0.05); SF-36 scores were significantly better in the observation group at 1 and 3 months postoperatively (all P <0.05). No adverse events occurred during the retrospective study period.