Ito Hideyuki, Ichihara Kiyoshi, Tamari Kotaro, Amano Tetsuya, Tanaka Shigeharu, Uchida Shigehiro
Department of Rehabilitation, Faculty of Wakayama Health Care Sciences, Takarazuka University of Medical and Health Care: 2252 Nakanoshima, Wakayama, Wakayama 640-8392, Japan.
Department of Clinical Laboratory Sciences, Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Japan.
J Phys Ther Sci. 2021 Mar;33(3):274-282. doi: 10.1589/jpts.33.274. Epub 2021 Mar 17.
[Purpose] For monitoring patients with knee osteoarthritis undergoing knee arthroplasty, the Timed Up and Go and maximum walking speed tests are commonly used. To provide appropriate peri-surgical rehabilitation, we evaluated the factors associated with postsurgical changes in Timed Up and Go and maximum walking speed results. [Participants and Methods] We enrolled 545 knee osteoarthritis patients undergoing either of the following knee arthroplasties: conventional total knee arthroplasty, minimally invasive total knee arthroplasty, and unicompartmental knee arthroplasty. Comfortable Timed Up and Go, maximum Timed Up and Go, and maximum walking speed were measured 2 weeks before and soon after surgery. Factors (gender, age, and surgical mode) that might influence changes in test results were evaluated by multiple regression analysis and a two-factor stratification diagram. [Results] Multiple regression analysis revealed that postsurgical changes in comfortable/maximum Timed Up and Go and maximum walking speed results were associated with age and surgical mode after adjustment for preoperative values. Two-factor diagrams showed that the older the patient, the greater was the slowdown in the Timed Up and Go test performed postoperatively. The levels of slowdown in the postoperative Timed Up and Go and maximum walking speed tests were the smallest in those who underwent conventional total knee arthroplasty, followed by those who underwent minimally invasive and unicompartmental knee arthroplasty. Among patients whose preoperative Timed Up and Go and maximum walking speed were slow, slowdown in Timed Up and Go was pronounced with age, and slowdown in maximum walking speed was higher in conventional total knee arthroplasty. [Conclusion] The changes in Timed Up and Go and maximum walking speed results 2 weeks after knee arthroplasty depended on age and surgical modes. These findings are relevant for the implementation of appropriate peri-surgical rehabilitation.
[目的] 对于接受膝关节置换术的膝骨关节炎患者，通常采用计时起立行走测试（Timed Up and Go）和最大步行速度测试。为了提供适当的围手术期康复治疗，我们评估了与计时起立行走测试和最大步行速度测试术后变化相关的因素。[参与者与方法] 我们纳入了545例接受以下膝关节置换术之一的膝骨关节炎患者：传统全膝关节置换术、微创全膝关节置换术和单髁膝关节置换术。在手术前2周和手术后不久测量舒适计时起立行走时间、最大计时起立行走时间和最大步行速度。通过多元回归分析和双因素分层图评估可能影响测试结果变化的因素（性别、年龄和手术方式）。[结果] 多元回归分析显示，在对术前值进行调整后，舒适/最大计时起立行走时间和最大步行速度测试的术后变化与年龄和手术方式相关。双因素图显示，患者年龄越大，术后进行的计时起立行走测试减速越大。术后计时起立行走测试和最大步行速度测试的减速程度在接受传统全膝关节置换术的患者中最小，其次是接受微创和单髁膝关节置换术的患者。在术前计时起立行走时间和最大步行速度较慢的患者中，计时起立行走时间的减速随年龄增长而明显，传统全膝关节置换术中最大步行速度的减速更高。[结论] 膝关节置换术后2周计时起立行走时间和最大步行速度测试结果的变化取决于年龄和手术方式。这些发现与实施适当的围手术期康复治疗相关。
