Amano Tetsuya, Tanaka Shigeharu, Ito Hideyuki, Morikawa Shinya, Uchida Shigehiro
Department of Physical Therapy, Faculty of Health and Medical Sciences, Tokoha University, Japan.
Faculty of Health and Social Services, Kanagawa University of Human Services, Japan.
J Orthop Sci. 2018 Nov;23(6):1027-1031. doi: 10.1016/j.jos.2018.07.015. Epub 2018 Aug 16.
We aimed to determine useful parameters for quantifying walking ability in patients with knee osteoarthritis.
This study included 621 Japanese patients with knee osteoarthritis scheduled to undergo total knee arthroplasty at any of 14 participating hospitals. Sex, age, body mass index, osteoarthritis severity (Kellgren-Lawrence grade), laterality, prior contralateral surgery, and pain were analyzed for their influence on walking ability, which was evaluated in terms of the 5-m walk test and the Timed Up and Go test outcomes during preoperative hospitalization. Patients were stratified based on dichotomized values of the independent influencing factors of walking ability, and the standard values for parameters describing walking ability were obtained.
Multiple regression analysis revealed that sex, age, and Kellgren-Lawrence grade were factors influencing walking ability (5-m walk test and Timed Up and Go test outcomes). Therefore, the patients were stratified by sex, age, and Kellgren-Lawrence grade. The standard values (median values) for walking time on the 5-m walk test among patients aged 60-74/75-89 years were: 3.90/4.64 vs. 4.27/5.12 s for men vs. women with Kellgren-Lawrence grade III; 4.26/5.60 vs. 4.80/6.05 s for men vs. women with Kellgren-Lawrence grade IV. Regarding walking speed on the 5-m test, the standard values were: 1.28/1.08 vs. 1.17/0.98 m/s for men vs. women with Kellgren-Lawrence grade III; 1.17/0.89 vs. 1.04/0.83 m/s for men vs. women with Kellgren-Lawrence grade IV. Finally, the standard values for time on the Timed Up and Go test were: 8.52/10.30 vs. 9.30/11.74 s for men vs. women with Kellgren-Lawrence grade III; 9.40/12.90 vs. 10.05/13.20 s for men vs. women with Kellgren-Lawrence grade IV.
The standard values reported in this study can be used to quantify walking ability decline in patients with knee osteoarthritis and to aid in the decision to consider total knee arthroplasty.
我们旨在确定用于量化膝骨关节炎患者步行能力的有用参数。
本研究纳入了621名计划在14家参与研究的医院中的任何一家接受全膝关节置换术的日本膝骨关节炎患者。分析了性别、年龄、体重指数、骨关节炎严重程度（凯尔格伦-劳伦斯分级）、患侧、对侧既往手术史和疼痛对步行能力的影响，步行能力通过术前住院期间的5米步行试验和计时起立行走试验结果进行评估。根据步行能力独立影响因素的二分值对患者进行分层，并获得描述步行能力参数的标准值。
多元回归分析显示，性别、年龄和凯尔格伦-劳伦斯分级是影响步行能力（5米步行试验和计时起立行走试验结果）的因素。因此，根据性别、年龄和凯尔格伦-劳伦斯分级对患者进行分层。60 - 74/75 - 89岁患者中，凯尔格伦-劳伦斯分级为III级的男性和女性在5米步行试验中的步行时间标准值（中位数）分别为：3.90/4.64秒对4.27/5.12秒；凯尔格伦-劳伦斯分级为IV级的男性和女性分别为4.26/5.60秒对4.80/6.05秒。关于5米试验中的步行速度，标准值分别为：凯尔格伦-劳伦斯分级为III级的男性和女性为1.28/1.08米/秒对1.17/0.98米/秒；凯尔格伦-劳伦斯分级为IV级的男性和女性为1.17/0.89米/秒对1.04/0.83米/秒。最后，计时起立行走试验的时间标准值分别为：凯尔格伦-劳伦斯分级为III级的男性和女性为8.52/10.30秒对9.3,0/11.74秒；凯尔格伦-劳伦斯分级为IV级的男性和女性为9.40/12.90秒对10.05/13.20秒。
本研究报告的标准值可用于量化膝骨关节炎患者步行能力的下降，并有助于辅助决定是否考虑进行全膝关节置换术。
