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髋关节置换术后,使用卡迪夫分类器可改善步态功能,且与患者报告的功能和疼痛有关。

Gait function improvements, using Cardiff Classifier, are related to patient-reported function and pain following hip arthroplasty.

机构信息

Arthritis Research UK Biomechanics and Bioengineering Centre, Cardiff University, Cardiff, UK.

Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

出版信息

J Orthop Res. 2022 May;40(5):1182-1193. doi: 10.1002/jor.25149. Epub 2021 Aug 11.

Abstract

Summarizing results of three-dimensional (3D) gait analysis into a comprehensive measure of overall gait function is valuable to discern to what extent gait function is affected, and later recovered after surgery and rehabilitation. This study aimed to investigate whether preoperative gait function, quantified and summarized using the Cardiff Classifier, can predict improvements in postoperative patient-reported activities of daily living, and overall gait function 1 year after total hip arthroplasty (THA). Secondly, to explore relationships between pre-to-post surgical change in gait function versus changes in patient-reported and performance-based function. Thirty-two patients scheduled for THA and 25 nonpathological individuals were included in this prospective cohort study. Patients were evaluated before THA and 1 year postoperatively using 3D gait analysis, patient-reported outcomes, and performance-based tests. Kinematic and kinetic gait parameters, derived from 3D gait analysis, were quantified using the Cardiff Classifier. Linear regressions investigated the predictive value of preoperative gait function on postoperative outcomes of function, and univariate correlations explored relationships between pre-to-post surgical changes in outcome measures. Preoperative gait function, by means of Cardiff Classifier, explained 35% and 30% of the total variance in change in patient-reported activities of daily living, and in gait function, respectively. Moderate-to-strong correlations were found between change in gait function and change in patient-reported function and pain, while no correlations were found between change in gait function and performance-based function. Clinical significance: Preoperative gait function predicts postsurgical function to a moderate degree, while improvements in gait function after surgery are more closely related to how patients perceive function than their maximal performance of functional tests.

摘要

将三维(3D)步态分析的结果总结为全面的步态功能综合衡量标准,对于辨别步态功能受影响的程度以及手术后和康复后的恢复程度非常有价值。本研究旨在探讨术前步态功能,使用卡迪夫分类器进行量化和总结,是否可以预测全髋关节置换术(THA)后患者报告的日常生活活动和整体步态功能的改善。其次,探索术前到术后步态功能变化与患者报告和基于表现的功能变化之间的关系。这项前瞻性队列研究纳入了 32 名计划接受 THA 的患者和 25 名非病理性个体。患者在 THA 前和术后 1 年分别接受 3D 步态分析、患者报告的结果和基于表现的测试评估。使用卡迪夫分类器对来自 3D 步态分析的运动学和动力学步态参数进行量化。线性回归分析了术前步态功能对术后功能结果的预测价值,单变量相关性分析了术后结果测量值的变化之间的关系。术前步态功能(通过卡迪夫分类器)解释了患者报告的日常生活活动和步态功能变化的总方差的 35%和 30%。发现步态功能的变化与患者报告的功能和疼痛的变化之间存在中度至强相关性,而步态功能的变化与基于表现的功能之间不存在相关性。临床意义:术前步态功能可以在一定程度上预测术后功能,而手术后步态功能的改善与患者对功能的感知程度更密切相关,而不是他们在功能测试中的最大表现。

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