Department of Rehabilitation, Yachiyo Medical Center, Tokyo Women's Medical University, Chiba, Japan.
Graduate Course of Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan.
BMC Musculoskelet Disord. 2023 Apr 1;24(1):254. doi: 10.1186/s12891-023-06364-3.
Although the importance of kinematic evaluation of the sit-to-stand (STS) test of total knee arthroplasty (TKA) patients is clear, there have been no reports analyzing STS during the 30-s chair sit-up test (30 s-CST) with a focus on kinematic characteristics. This study aimed to demonstrate the clinical utility of kinematic analysis of STS during the 30 s-CST by classifying STS into subgroups based on kinematic parameters, and to determine whether differences in movement strategies are expressed as differences in clinical outcomes.
The subjects were all patients who underwent unilateral TKA due to osteoarthritis of the knee and were followed up for one year postoperatively. Forty-eight kinematic parameters were calculated using markerless motion capture by cutting STS in the 30 s-CST. The principal components of the kinematic parameters were extracted and grouped by kinematic characteristics based on the principal component scores. Clinical significance was examined by testing whether differences in patient-reported outcome measures (PROMs) were observed.
Five principal components were extracted from the 48 kinematic parameters of STS and classified into three subgroups (SGs) according to their kinematic characteristics. It was suggested that SG2, using a kinematic strategy similar to the momentum transfer strategy shown in previous studies, performed better in PROMs and, in particular, may be associated with achieving a "forgotten joint", which is considered the ultimate goal after TKA.
Clinical outcomes differed according to kinematic strategies used STS, suggesting that kinematic analysis of STS in 30 s-CST may be useful in clinical practice.
This study was approved by the Medical Ethical Committee of the Tokyo Women's Medical University (approval number: 5628 on May 21, 2021).
虽然全膝关节置换术(TKA)患者坐站(STS)测试的运动学评估的重要性是明确的,但目前还没有报告分析 30 秒坐起测试(30 s-CST)中 STS 的运动学特征。本研究旨在通过基于运动学参数对 STS 进行分类,展示 30 s-CST 中 STS 运动学分析的临床实用性,并确定运动策略的差异是否表现为临床结果的差异。
所有受试者均为因膝关节骨关节炎接受单侧 TKA 治疗的患者,术后随访 1 年。通过无标记运动捕捉技术在 30 s-CST 中切割 STS,计算了 48 个运动学参数。根据主成分得分,从运动学参数中提取主要成分,并根据运动学特征对其进行分组。通过测试患者报告的结果测量(PROMs)是否存在差异,来检查临床意义。
从 STS 的 48 个运动学参数中提取了 5 个主成分,并根据其运动学特征将其分为 3 个亚组(SG)。SG2 采用类似于先前研究中动量传递策略的运动学策略,在 PROMs 中表现更好,特别是可能与实现“遗忘关节”有关,这被认为是 TKA 后的最终目标。
根据 STS 所使用的运动学策略,临床结果存在差异,这表明 30 s-CST 中 STS 的运动学分析在临床实践中可能是有用的。
本研究得到了东京女子医科大学医学伦理委员会的批准(2021 年 5 月 21 日批准号:5628)。