J Orthop Sports Phys Ther. 2021 Jul;51(7):362-371. doi: 10.2519/jospt.2021.10299. Epub 2021 May 10.
To (1) classify patients who are recovering from total knee arthroplasty (TKA) based on walking speed during an early physical therapy program, and (2) assess whether walking-speed trajectory predicts performance on the timed up-and-go (TUG) test.
Cohort study.
We included 218 patients from a 10-day physical therapy program after TKA. A latent class mixed model was used to classify patients according to their walking-speed trajectory during the program. We assessed the change in TUG test score from pre-TKA to 6 weeks and 1 year after TKA. The association between change in TUG test score and walking-speed trajectory was assessed using multivariable regression.
There were 2 groups with distinct walking-speed trajectories: a high-gain group (46%) and a low-gain group (54%). There was no significant association between change in TUG test score and walking-speed trajectory after TKA and physical therapy. Function (based on TUG test performance) improved for all patients 1 year after TKA, irrespective of walking-speed trajectory (ie, high or low gain) early in postoperative physical therapy.
Although we distinguished different groups based on functional outcomes during physical therapy, the clinical relevance of classifying patients based on walking speed remains unclear, as it did not predict short- and long-term functional outcomes. .
（1）根据早期物理治疗方案中的步行速度对全膝关节置换术（TKA）后康复的患者进行分类，（2）评估步行速度轨迹是否可预测计时起立行走（TUG）测试的表现。
队列研究。
我们纳入了来自 TKA 后 10 天物理治疗方案的 218 名患者。使用潜在类别混合模型根据患者在该方案期间的步行速度轨迹对其进行分类。我们评估了 TUG 测试在 TKA 前、6 周和 1 年后的评分变化。使用多变量回归评估 TUG 测试评分变化与步行速度轨迹之间的关联。
存在 2 个具有明显不同步行速度轨迹的组：高增益组（46%）和低增益组（54%）。TKA 和物理治疗后，TUG 测试评分的变化与步行速度轨迹之间没有显著关联。所有患者在 TKA 后 1 年均改善了功能（基于 TUG 测试表现），而与术后早期物理治疗中的步行速度轨迹（即高或低增益）无关。
尽管我们根据物理治疗期间的功能结果区分了不同的组别，但基于步行速度对患者进行分类的临床意义尚不清楚，因为它无法预测短期和长期的功能结果。
