Hiyama Yoshinori, Wada Osamu, Nakakita Satoshi, Mizuno Kiyonori
Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, Ota-ku, Tokyo, Japan.
Anshin Hospital, Kobe, Hyogo, Japan.
J Knee Surg. 2017 May;30(4):304-308. doi: 10.1055/s-0036-1584562. Epub 2016 Jun 30.
Restricted mobility is a major issue for individuals with knee osteoarthritis (OA). Total knee arthroplasty (TKA) is expected to improve mobility in people with knee OA by alleviating pain and improving walking ability. The present study aimed to describe the time course of mobility after TKA and to identify the factors affecting mobility after TKA. This prospective cohort study comprised 62 patients undergoing TKA, evaluated at 1 month preoperatively, as well as at 1, 3, and 6 months postoperatively. Outcome measures included mobility (Life Space Assessment; LSA), self-efficacy for walking tasks (modified Gait Efficacy Scale; mGES), and physical (quadriceps strength and the Timed Up and Go; TUG test) and knee function (the Knee Society Score questionnaire). As a result, a total of 59 patients (mean age: 71.7 years; range: 58-79 years) had completed all postoperative assessments. Compared with preoperative values, patients showed decreased LSA and mGES scores at 1 month postoperatively. We found improvements in those scores from the 1-month to the 3- and 6-month assessment; however, there was no difference in the LSA and mGES scores between the preoperative and 6-month assessment. We also found improvements in quadriceps strength, the TUG score, the Knee Society Score, and pain scores from the preoperative to the 6-month assessment. Additionally, at 6 months postoperatively, the mGES and TUG scores significantly affected mobility. Our results suggest that mobility at 6 months after TKA is similar to preoperative level and self-efficacy for walking tasks and functional ability are important factors in improving mobility after TKA.
行动受限是膝关节骨关节炎(OA)患者的一个主要问题。全膝关节置换术(TKA)有望通过减轻疼痛和改善步行能力来提高膝关节OA患者的行动能力。本研究旨在描述TKA术后行动能力的时间进程,并确定影响TKA术后行动能力的因素。这项前瞻性队列研究包括62例行TKA的患者,在术前1个月以及术后1、3和6个月进行评估。结果指标包括行动能力(生活空间评估;LSA)、步行任务的自我效能感(改良步态效能量表;mGES)、身体指标(股四头肌力量和计时起立行走测试;TUG测试)以及膝关节功能(膝关节协会评分问卷)。结果,共有59名患者(平均年龄:71.7岁;范围:58 - 79岁)完成了所有术后评估。与术前值相比,患者术后1个月时LSA和mGES评分降低。我们发现从1个月到3个月和6个月评估时这些评分有所改善;然而,术前和6个月评估时LSA和mGES评分没有差异。我们还发现从术前到6个月评估时股四头肌力量、TUG评分、膝关节协会评分和疼痛评分有所改善。此外,术后6个月时mGES和TUG评分显著影响行动能力。我们的结果表明,TKA术后6个月的行动能力与术前水平相似,步行任务的自我效能感和功能能力是改善TKA术后行动能力的重要因素。