Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, 6-2-23, Morikita-machi, Higashinada-ku, Kobe 658-0001, Japan; Department of Rehabilitation, Kobe City Hospital Organization, Kobe City Medical Center, West Hospital, 2-4, Ichibancho, Nagata-ku, Kobe, Hyogo 653-0013, Japan.
Department of Physical Medicine and Rehabilitation, Kansai Medical University, 18-89, Uyamahigashimachi, Hirakata, Osaka 573-1136, Japan.
Knee. 2022 Aug;37:143-152. doi: 10.1016/j.knee.2022.06.005. Epub 2022 Jun 29.
This study was performed to (i) compare gait parameters obtained from inertial sensors attached to the lower trunk and foot between patients in the early postoperative period after total knee arthroplasty (TKA) and healthy age- and sex-matched controls and (ii) elucidate the association between the gait parameters and patient-reported outcome measures (PROMs).
The gait performance of 19 patients who had undergone TKA was assessed using inertial sensors and PROMs obtained from the Knee Injury and Osteoarthritis Outcome Score (KOOS) 1 week before hospital discharge. The patients walked along a 15-m walkway and we calculated the following gait parameters: walking speed, coefficient of variation (CV) of stride time, unbiased autocorrelation coefficient (AC), harmonic ratio (HR), and symmetry index (SI). The same gait parameter data from 19 age- and sex-matched healthy adults (controls) were obtained from our past study.
The TKA group demonstrated slower walking speed, larger CV of stride time, lower HR in all three directions, lower AC in the vertical direction, and higher SI in the vertical direction than the healthy control group (all p < 0.05). Correlation analysis revealed that the SI in the anteroposterior direction was significantly correlated with the KOOS symptoms subscore and ADL subscore (p < 0.05).
Patients in the early postoperative period after TKA exhibited worse gait performance as assessed by inertial sensors compared with healthy controls. Gait symmetry was correlated with PROMs. These results indicate the usefulness of assessing gait parameters after TKA.
本研究旨在:(i) 比较全膝关节置换术(TKA)后早期和健康的年龄及性别匹配的对照组患者的下肢躯干和足部附着惯性传感器获得的步态参数;(ii) 阐明步态参数与患者报告的结果测量(PROM)之间的关联。
使用惯性传感器和 Knee Injury and Osteoarthritis Outcome Score(KOOS)1 周前获得的 PROM 评估了 19 名接受 TKA 的患者的步态表现。患者沿着 15 米的走道行走,我们计算了以下步态参数:行走速度、步长时间变异系数(CV)、无偏自相关系数(AC)、谐波比(HR)和对称指数(SI)。从我们过去的研究中获得了 19 名年龄和性别匹配的健康成年人(对照组)的相同步态参数数据。
TKA 组的行走速度较慢,步长时间 CV 较大,所有三个方向的 HR 较低,垂直方向的 AC 较低,垂直方向的 SI 较高(均 p<0.05)。相关分析显示,前向后方向的 SI 与 KOOS 症状子评分和 ADL 子评分显著相关(p<0.05)。
与健康对照组相比,TKA 后早期的患者步态表现较差,惯性传感器评估。步态对称性与 PROM 相关。这些结果表明在 TKA 后评估步态参数的有用性。