Effects of injection-drug injury on ankle mobility and chronic venous disorders: Physical injury

Barbara Pieper, Thomas N. Templin, Thomas J. Birk, Robert S. Kirsner

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Purpose: To identify potential confounders and test a causal model of injection-site risk, chronic venous disorders (CVD), and ankle mobility. The reliability and validity of goniometry measurements of ankle mobility were also of interest because they are seldom performed in people with a history of injection-drug use. Design: The study was a test-retest design, consisting of 104 participants from a methadone maintenance treatment center. Methods: Each participant provided demographic information, health and drug histories, and underwent bilateral ankle goniometric measures of dorsiflexion, plantar flexion, inversion, and eversion. The clinical portion of the Clinical-Etiology-Anatomy- Pathophysiology (CEAP)was used to classify CVD severity. Findings: Reliability of goniometry measurements ranged from.70 to.90. Causal modeling supported hypotheses of increased risk from leg injection and reciprocal effects involving ankle mobility and disease progression. Ankle inversion mobility was the strongest indicator of ankle mobility. Conclusions: Injury to the lower extremities from IDU affected CVD and mobility. Further research should include assessment of comorbidity and other potential confounders. Ankle inversion should remain part of the goniometry assessment.

Original languageEnglish (US)
Pages (from-to)312-318
Number of pages7
JournalJournal of Nursing Scholarship
Issue number4
StatePublished - Dec 2007


  • Ankle goniometry
  • Chronic venous disorders
  • Injection drug use

ASJC Scopus subject areas

  • Nursing(all)


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