Department of Physical Therapy, Faculty of Social Work Studies, Josai International University, 1 Gumyo, Togane-City, Chiba-Prefecture, 283-8555, Japan.
Department of Physical Therapy, Faculty of Social Work Studies, Josai International University, 1 Gumyo, Togane-City, Chiba-Prefecture, 283-8555, Japan.
Gait Posture. 2022 Jan;91:14-18. doi: 10.1016/j.gaitpost.2021.10.003. Epub 2021 Oct 6.
Patient-reported outcome measures (PROMs) have recently been considered as indicating clinical outcomes after total hip arthroplasty (THA). Although various factors are reportedly associated with post-THA and PROMs, the relationship with gait parameters, which are objective assessment factors after THA, remains unclear.
What is the relationship between PROMs and gait biomechanical factors four weeks after THA?
Forty-five patients (six men and 39 women) who underwent THA were included. Three-dimensional gait analysis was performed four weeks post-THA; joint angle, internal moment, and power of the lower extremity at the first and second peaks of the vertical component of the floor reaction force were assessed for the operated side. PROMs were evaluated using the Japanese Orthopedic Association Hip Disease Evaluation Questionnaire (JHEQ). The relationship between the JHEQ score and extracted gait parameters was analyzed using gender and gait speed as control factors.
For the JHEQ sub-domain, movement was positively correlated with the internal knee extension moment values at the first peak (r = 0.347). There was no significant correlation between JHEQ and the internal hip abduction moment value at the first peak. Mental status was negatively correlated with the hip flexion angle value at the second peak (r = -0.373), and positively correlated with the hip flexion moment value (r = 0.348). Total JHEQ scores and mental status were negatively correlated with the power of hip flexion value at the second peaks, respectively (r = -0.316, -0.444).
The results of this study may provide recovery guidelines to be used as an index for gait assessment in the early post-THA period. Further studies are needed to verify whether gait parameters can improve PROMs in the early post-THA period.
患者报告的结局测量（PROMs）最近被认为是全髋关节置换术（THA）后临床结局的指标。尽管有报道称各种因素与 THA 后和 PROMs 相关，但与步态参数的关系，这是 THA 后客观评估因素，仍不清楚。
THA 后四周 PROMs 与步态生物力学因素之间的关系如何？
纳入 45 例（6 名男性和 39 名女性）接受 THA 的患者。THA 后 4 周进行三维步态分析；评估下肢在地面反力垂直分量的第一和第二峰值时的关节角度、内力矩和功率。使用日本矫形协会髋关节疾病评估问卷（JHEQ）评估 PROMs。使用性别和步态速度作为控制因素，分析 JHEQ 评分与提取的步态参数之间的关系。
对于 JHEQ 子量表，运动与第一峰值时的膝关节伸展内力矩值呈正相关（r=0.347）。JHEQ 与第一峰值时的髋关节外展内力矩值之间无显著相关性。精神状态与第二峰值时的髋关节屈曲角度值呈负相关（r=-0.373），与髋关节屈曲力矩值呈正相关（r=0.348）。总 JHEQ 评分和精神状态与第二峰值时的髋关节屈曲功率呈负相关，分别为（r=-0.316，-0.444）。
本研究的结果可能为步态评估提供康复指南，作为 THA 后早期的指标。需要进一步的研究来验证步态参数是否可以改善 THA 后早期的 PROMs。
