Department of Orthopaedic Surgery, University of Yamanashi, Yamanashi, Japan.
Department of Rehabilitation Medicine, University of Yamanashi, Yamanashi, Japan.
Mod Rheumatol. 2021 Sep;31(5):1050-1058. doi: 10.1080/14397595.2020.1823552. Epub 2020 Oct 2.
Patients requiring total hip arthroplasty (THA) may possibly have locomotive syndrome (LS). Therefore, we investigated changes of LS in patients undergoing THA and clarified key factors that affected LS stage.
A prospective cohort study was conducted with 88 patients undergoing THA (74 females, 14 males, mean age: 67.6 years). Data collected using LS stage, stand-up test, two-step test, and 25-question Geriatric Locomotive Function Scale results were evaluated before THA, and 6 months, 1 year, and 2 years after THA. Key factors were determined using multivariate analysis and receiver operating characteristic (ROC) curve analysis.
Before THA, all patients had fallen LS (stage1: 3.4% and stage2: 96.6%). Overall, 56.8% patients improved their LS stage, and 17.0% of patients overcame LS at 2 years after THA. The key factors that affected LS stage were preoperative two-step test and age. ROC analyses showed a preoperative two-step test score of 0.988 and an age of 67.5 years as a cut-off value for the change of LS stage.
Patients experiencing LS due to hip disorders have the potential to recover after THA. Additional postoperative training may be beneficial for patients with low preoperative two-step test scores to improve their LS stage.
接受全髋关节置换术（THA）的患者可能患有运动障碍综合征（LS）。因此，我们研究了接受 THA 的患者 LS 的变化，并阐明了影响 LS 阶段的关键因素。
对 88 例行 THA 的患者（74 名女性，14 名男性，平均年龄：67.6 岁）进行前瞻性队列研究。使用 LS 阶段、站立测试、两步测试和 25 项老年运动功能量表结果收集数据，在 THA 之前以及 THA 后 6 个月、1 年和 2 年进行评估。使用多变量分析和受试者工作特征（ROC）曲线分析确定关键因素。
在 THA 之前，所有患者均有跌倒 LS（第 1 期：3.4%和第 2 期：96.6%）。总体而言，56.8%的患者改善了 LS 阶段，17.0%的患者在 THA 后 2 年克服了 LS。影响 LS 阶段的关键因素是术前两步测试和年龄。ROC 分析显示术前两步测试得分为 0.988，年龄为 67.5 岁作为 LS 阶段变化的截断值。
由于髋关节疾病而患有 LS 的患者在接受 THA 后有恢复的潜力。术后额外的训练可能对术前两步测试得分较低的患者改善 LS 阶段有益。
