Hurworth Mark, Evans Jade M, Gibbons Rebekah, Mackie Katherine E, Edmondston Stephen J
Murdoch Orthopaedic Clinic, St John of God Murdoch Hospital, Murdoch, Western Australia, Australia.
Murdoch Centre for Orthopaedic Research, St John of God Murdoch Hospital, Murdoch, Western Australia, Australia.
Arthroplast Today. 2021 Jun 15;9:118-121. doi: 10.1016/j.artd.2021.05.007. eCollection 2021 Jun.
Lower limb muscle power is emerging as an important determinant of patient function after knee injury or surgery. This study tested proof of concept of a cycle sprint test for the evaluation of lower limb muscle power, as an outcome measure for patients having total knee arthroplasty (TKA).
Thirty-two patients were enrolled, of which 16 completed all follow-ups (3, 6, and 12 months). All patients completed the Oxford Knee Score and Knee Injury and Osteoarthritis Outcome Score questionnaires, a 10-m walk test, and 30-second sit-stand test. A trainer-mounted road cycle fitted with an instrumented crank was used for the cycle sprint test. Maximum muscle power was measured from 3, 10-second maximal efforts.
Significant improvements in Oxford Knee Score and Knee Injury and Osteoarthritis Outcome scores relative to baseline were achieved at each follow-up ( < .001), and functional test performance improved significantly at 6 and 12 months ( < .001). Compared with the baseline of 268W, muscle power was significantly lower at 3 months (239W, -13%, < .05) and significantly higher at 12 months (308W, +12%, < .05).
The concept of muscle power measurement using a cycle sprint test before and after TKA has been demonstrated in this study. Identification of individuals with lower limb muscle power deficits after TKA may inform rehabilitation programs and enhance long-term outcomes.
下肢肌肉力量正逐渐成为膝关节损伤或手术后患者功能的重要决定因素。本研究测试了一项用于评估下肢肌肉力量的自行车冲刺试验的概念验证，作为全膝关节置换术（TKA）患者的一项结局指标。
招募了32名患者，其中16名完成了所有随访（3个月、6个月和12个月）。所有患者均完成了牛津膝关节评分和膝关节损伤与骨关节炎结局评分问卷、10米步行试验和30秒坐立试验。使用一台安装在训练器上的公路自行车，配备有测量装置的曲柄，用于自行车冲刺试验。通过3次10秒的最大努力来测量最大肌肉力量。
每次随访时，牛津膝关节评分以及膝关节损伤与骨关节炎结局评分相对于基线均有显著改善（<0.001），并且功能测试表现在6个月和12个月时显著改善（<0.001）。与基线的268瓦相比，肌肉力量在3个月时显著降低（239瓦，-13%，<0.05），在12个月时显著升高（308瓦，+12%，<0.05）。
本研究证明了在TKA前后使用自行车冲刺试验测量肌肉力量的概念。识别TKA后存在下肢肌肉力量缺陷的个体，可为康复计划提供参考并改善长期结局。
