Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA.
Arch Phys Med Rehabil. 2011 Oct;92(10):1624-9. doi: 10.1016/j.apmr.2011.05.010. Epub 2011 Aug 12.
To examine changes in weight-bearing (WB) asymmetry during sit-stand transitions for individuals during the first 6 months after unilateral total knee arthroplasty (TKA). Relationships between WB asymmetry, clinical measures of knee impairment, and functional mobility also were evaluated.
Prospective repeated-measures design.
Clinical research laboratory.
People (N=36) with knee osteoarthritis (OA) scheduled to undergo unilateral TKA and a control (CTL) group (N=17 healthy people) were enrolled.
The TKA group participated in acute, home, and outpatient phases of exercise-based rehabilitation.
WB asymmetry measured during a 5-Times Sit-to-Stand Test (FTSST) based on average vertical ground reaction force under each foot, self-reported knee pain using a numerical pain rating scale, knee active range of motion symmetry, knee extensor strength symmetry, FTSST time, 6-minute walk test distance, and Stair Climbing Test time.
Compared with preoperative values, the TKA group showed greater WB asymmetry at 1 month after surgery (P<.001). By 6 months, the TKA group had less WB asymmetry than preoperative values (P<.001), which was not different from the CTL group. Symmetry in WB correlated with functional outcomes and symmetry of quadriceps strength for the TKA group 6 months postoperatively.
Patients with unilateral knee OA showed WB asymmetry during sit-stand transitions early after unilateral TKA that improved by 6 months after surgery and was no different from that for healthy people of similar age. For people in the first 6 months after TKA, greater symmetry was related to better function and strength symmetry.
研究单侧全膝关节置换术(TKA)后 6 个月内个体在坐站转换过程中负重(WB)不对称性的变化。还评估了 WB 不对称性与膝关节损伤的临床测量指标和功能性移动性之间的关系。
前瞻性重复测量设计。
临床研究实验室。
招募了患有膝骨关节炎(OA)并计划接受单侧 TKA 的人群(TKA 组,N=36)和对照组(CTL 组,健康人群,N=17)。
TKA 组参加了基于急性、家庭和门诊的锻炼为基础的康复。
基于每个脚的平均垂直地面反作用力的 5 次坐-站测试(FTSST)中的 WB 不对称性、使用数字疼痛评分量表报告的膝关节疼痛、膝关节主动活动范围的对称性、膝关节伸肌力量的对称性、FTSST 时间、6 分钟步行测试距离和爬楼梯测试时间。
与术前值相比,TKA 组术后 1 个月时 WB 不对称性更大(P<.001)。到 6 个月时,TKA 组的 WB 不对称性比术前值小(P<.001),与 CTL 组无差异。术后 6 个月,TKA 组的 WB 对称性与功能性结果和股四头肌力量的对称性相关。
单侧膝 OA 患者在单侧 TKA 后早期进行坐站转换时表现出 WB 不对称性,这种情况在术后 6 个月时得到改善,与年龄相似的健康人群无差异。对于 TKA 后 6 个月内的人群,更大的对称性与更好的功能和力量对称性相关。