Correlation between objective gait parameters and subjective score measurements before and after total knee arthroplasty (original) (raw)
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Gait assessment as a functional outcome measure in total knee arthroplasty: a cross-sectional study
BMC Musculoskeletal Disorders, 2015
Background: The aim of the study was to assess gait in total knee arthroplasty (TKA) patients, using a technique that can to be used on a routine basis in a busy orthopaedic clinic. Methods: A total of 103 subjects were recruited: 29 pre-op TKA patients; 17 TKA patients at 8 weeks post-op; 28 TKA patients at 52 weeks post-op; and 29 age-matched controls. Inertial measurement units (IMUs) were used to assess gait. Limb segment angles, knee angle and temporal parameters of gait were calculated. Specific gait parameters were quantified, and data analysed using MANOVA and discriminant analysis. Results: The gait of TKA patients as a group was only slightly improved at 12 months when compared with the pre-operative group, and both groups were significantly different to controls in several variables. Knee flexion range in stance was the most important variable in discriminating between patients and controls; knee flexion range in swing was the only variable that showed a significant difference between pre-and post-operative patients. When considered individually, only 1/29 patient was within the normal range for this variable pre-operatively, but 9/28 patients were within the normal range 12 months post-operatively. Conclusions: Even after 12 months after surgery, many TKA patients have not improved their gait relative to pre-operative patients. Routine gait assessment may be used to guide post-operative rehabilitation, and to develop strategies to improve mobility of these patients.
Orthopaedic surgery, 2016
To evaluate the effects of surgery and rehabilitation on patients undergoing total knee arthroplasty (TKA). Twelve patients and 12 healthy controls were enrolled and their clinical scores evaluated by a doctor. Gait data, including walking velocity, stride length, single support time, foot fall and swing power, were collected using a portable gait analyzer from 12 patients before and 6 weeks and 6 months after surgery and from 12 healthy controls. The gait data and clinical scores at selected time points were compared and correlations between gait characteristics and clinical scores assessed. Clinical knee and knee function scores increased significantly from before surgery to 6 weeks to 6 months after surgery (P < 0.001). The only significant differences identified were for single support time on the diseased side between before surgery and 6 months after surgery (P = 0.031) and for foot fall with the diseased side between 6 weeks and 6 months after surgery (P = 0.016). Foot fal...
Functional outcome of knee arthroplasty is dependent upon the evaluation method employed
European Journal of Orthopaedic Surgery & Traumatology, 2009
It is becoming increasingly important to evaluate surgical procedures beyond pain relief and implant survival. Patient satisfaction and objective functional assessment is now as relevant. The aim of this study was to establish the functional differences and patient perceptions between unicompartmental knee replacement (UKR) and total knee replacement (TKR). In a prospective study 52 TKR patients were compared to 24 UKR (at preoperative, 3, 6 months and 1 year postoperative). The disease specific KSS and Womac (pain and function subscores), the generic SF36 (pain, function and patient perception subscores) and the Dynaport Ò Knee Test, a validated performance-based knee test using accelerometers to score function during activities of daily living, was utilized. Preoperative UKR patients had significantly higher KSS function and the Dynaport Ò Knee Test (P \ 0.05), but despite being younger, with different indication, they were not different to TKR with regards to function and pain subscores of Womac and SF36. Regarding preoperative perception, UKR patients reported better physical and social function but subjectively felt worse than TKR patients regarding health, emotion and mental status (n.s.). At one year, postoperative perception scores for both groups increased significantly, with UKR retaining functional lead and UKR patients also felt superior regarding health, emotion and mental status (n.s.). Postoperative recovery regarding KSS, Womac, and SF36-pain was steep only during the first 3 months with near equal values for both TKR and UKR. It was found that SF36-Function recovery was not significant, but UKR also scored higher than TKR. Only functional scores by the Dynaport Ò Knee Test showed continued improvement and maintained the functional advantage of UKR patients throughout recovery. UKR and TKR patients have different age demographics, indications and perceptions, but clinical outcome scores do not equally capture these differences, especially with regards to function. Postoperative functional benefits of UKR seem to be due mainly to the superior preoperative conditions. Appreciation of recovery with generic, disease specific and functional measurements appears invaluable.
Iranian Rehabilitation Journal, 2013
The aim of this study was to extract suitable spatiotemporal and kinematic parameters to determine how Total Knee Replacement (TKR) alters patients' knee kinematics during gait, using a rapid and simplified quantitative two-dimensional gait analysis procedure. Methods: Two-dimensional kinematic gait pattern of 10 participants were collected before and after the TKR surgery, using a 60 Hz camcorder in sagittal plane. Then, the kinematic parameters were extracted using the gait data. A student t-test was used to compare the group-average of spatiotemporal and peak kinematic characteristics in the sagittal plane. The knee condition was also evaluated using the Oxford Knee Score (OKS) Questionnaire to ensure that each subject was placed in the right group. Results: The results showed a significant improvement in knee flexion during stance and swing phases after TKR surgery. The walking speed was increased as a result of stride length and cadence improvement, but this increment was not statistically significant. Both post-TKR and control groups showed an increment in spatiotemporal and peak kinematic characteristics between comfortable and fast walking speeds. Conclusion: The objective kinematic parameters extracted from 2D gait data were able to show significant improvements of the knee joint after TKR surgery. The patients with TKR surgery were also able to improve their knee kinematics during fast walking speed equal to the control group. These results provide a good insight into the capabilities of the presented method to evaluate knee functionality before and after TKR surgery and to define a more effective rehabilitation program.
Reliability of the 50-foot walk test and 30-sec chair stand test in total knee arthroplasty
Acta Ortopédica Brasileira, 2015
Objective: To investigate the reliability of the 50-Foot Walk Test (50 FWT) and 30-second Chair Stand Test (30 CST) in patients who have undergone total knee arthroplasty (TKA). Methods: The study was designed as a test-retest research. Thirty-three patients who would undergo bilateral TKA were recruited. The tests 30 CST and 50 FWT were performed twice on the same day with 5-minute intervals, respectively. Between the first and second tests, patients waited for an hour on sitting position in order to prevent fatigue. In addition to these tests, we registered the knee pain experienced by the patients using a 100 mm VAS scale. Results: The 50 FWT and 30 CST showed excellent reliability. ICC for 50 FWT and 30 CST were 0.97 and 0.92, respectively. SRD95 was 1.07 for 50 FWT and 0.96 for 30 CST. Conclusions: According to results of this study, both 50 FWT and 30 CST have excellent reliability in patients with TKA. These tests are simple, no time consuming and constitute sensitive methods to measure the functional performance in patients with TKA in the clinical settings. Clinicians and researchers may use these tests to quantify even small changes in functional performance for patients with TKA. Level of Evidence III, Diagnostic Study.
Gait analysis of patients following totalcondylar knee arthroplasty
Acta chirurgica Iugoslavica, 2015
The aim of this study was to evaluate total knee arthroplasty success, throw gait analysis of patients who were underwent a surgery according to objective indicators. Material and methods: Fourteen patients were participated in our study who suffered from a certain type of gonarthrosis. Data were gathered(collected) using a commercial OptiTrack system for motion recording using six infrared cameras. Markers were placed on patients? lower extremities, on previously determined anatomical regions. After recording the data were processed using computing environment MATLAB. Results: Observing our lab results we noticed a significant reduction in range of motion (ROM) of arthritic knees in relation to the healthy knees. ROM reduction is primarily related to flexion and extension, as well as to medial and lateral translation. Following the TKA, ROM increases, and these values get close to the values that were measured in a healthy knee. The results were presented using graphs for a healthy...