Ouellet Denise, Moffet Hélène
Laval University and CIRRIS, Quebec Rehabilitation Institute, Quebec City, Canada.
Arthritis Rheum. 2002 Oct 15;47(5):484-93. doi: 10.1002/art.10652.
To quantify the locomotor deficits before and 2 months after a total knee arthroplasty (TKA) in patients with osteoarthritis of the knee, and to compare pre- and postoperative performance.
Locomotor capacity of patients was evaluated using laboratory gait and stair-ascent evaluations (kinematic and kinetic variables, electromyographic activity of 4 muscles of both lower limbs, and spatiotemporal parameters), the timed Up & Go (TUG), and the 6-minute walk (6MW) test.
Large locomotor deficits (increased hip flexion, decreased excursions of the knee and ankle, smaller extensor and flexor moments of force at the 3 joints, and muscle activation levels lower in all muscles tested) are still present in patients, particularly in the single-limb support subphase before and 2 months after TKA. These deficits explain the slower walk and stair-ascent speeds and a reduced performance at the TUG and 6MW tests.
These results emphasize the need for more careful followup and intensive rehabilitation programs in the first months following TKA.
量化膝关节骨关节炎患者全膝关节置换术(TKA)前及术后2个月的运动功能障碍,并比较术前和术后的表现。
通过实验室步态和上楼梯评估(运动学和动力学变量、双下肢4块肌肉的肌电图活动以及时空参数)、定时起立行走测试(TUG)和6分钟步行测试(6MW)对患者的运动能力进行评估。
患者仍存在较大的运动功能障碍(髋部屈曲增加、膝关节和踝关节活动范围减小、三个关节处伸肌和屈肌力矩较小以及所有测试肌肉的肌肉激活水平较低),尤其是在TKA术前和术后2个月的单腿支撑子阶段。这些功能障碍解释了行走和上楼梯速度较慢以及在TUG和6MW测试中表现下降的原因。
这些结果强调了在TKA术后的头几个月需要更仔细的随访和强化康复计划。