Özden Fatih, Uysal İsmail, Tümtürk İsmet, Özyer Fatih
Department of Health Care Services, Köyceğiz Vocational School of Health Services, Muğla Sıtkı Koçman University, Muğla, Turkey.
Department of Health Care Services, Fethiye Vocational School of Health Services, Muğla Sıtkı Koçman University, Muğla, Turkey.
J Am Med Dir Assoc. 2024 Jan;25(1):112-117. doi: 10.1016/j.jamda.2023.09.032. Epub 2023 Nov 3.
The existing literature on total knee arthroplasty (TKA) does not provide clear data on step reaction time and proprioception and gait in shaped pathways. This study investigated the relationship between proprioception and reaction time with walking performance in shaped pathways in older patients undergoing TKA.
A cross-sectional observational study.
An orthopedic outpatient clinic with 103 older patients with TKA after a minimum of 6 months after surgery.
Participants were evaluated with Figure-of-8 Walk Test (F8WT), L Test, Tinnetti Gait Test (TGT), proprioception measurement with an app-based inclinometer, and step reaction time (SRT) test. The same assessor carried out all evaluations.
F8WT showed a strong correlation with SRT-right, SRT-left, and Tinetti Gait Test (TGT), respectively (r = 0.628, r = 0.619, r = -0.615, P < .01). In addition, F8WT was moderately correlated with Right Leg Proprioception Test (RLPT) and Left Leg Proprioception Test (LLPT), respectively (r = 0.487, r = 0.439, P < .01). There was a moderate correlation between L Test with RLRT, LLRT, and TGT, respectively (r = 0.597, r = 0.584, r = -0.542, P < .01). Besides, there was a weak positive correlation between L Test with RLPT and LLPT, respectively (r = 0.394, r = 0.335, P < .01). A regression model showed that the L test was related to RLRT, LLRT, and TGT (R = 0.432, P < .001). The higher ability of the L test was weakly associated with higher levels of TGT (standardized β = -0.28, P = .0012). Besides, regression analysis also proved that F8WT was related to RLRT, LLRT, and TGT (R = 0.522, P < .001). The most highly associated parameter was LLRT (standardized β = 0.958, P = .003).
Gait in shaped pathways is associated with proprioception, reaction time, and balance ability in older patients with TKA. Therefore, proprioception, reaction time, and balance should be considered to improve the shaped pathway walking performance of patients after bilateral, right, or left TKA surgery.
现有的全膝关节置换术（TKA）文献并未提供关于形状路径中步反应时间和本体感觉及步态的明确数据。本研究调查了 TKA 后 6 个月以上的老年患者在形状路径中本体感觉和反应时间与行走能力之间的关系。
横断面观察性研究。
在一家骨科门诊，共有 103 名 TKA 后的老年患者入组，这些患者术后至少 6 个月。
参与者接受 8 字形步行测试（F8WT）、L 测试、 Tinnetti 步态测试（TGT）、基于应用程序的倾斜计的本体感觉测量和步反应时间（SRT）测试。由同一位评估者进行所有评估。
F8WT 与 SRT-右、SRT-左和 Tinetti 步态测试（TGT）分别具有很强的相关性（r=0.628，r=0.619，r=-0.615，P<.01）。此外，F8WT 与右下肢本体感觉测试（RLPT）和左下肢本体感觉测试（LLPT）分别呈中度相关（r=0.487，r=0.439，P<.01）。L 测试与 RLRT、LLRT 和 TGT 之间存在中度相关性（r=0.597，r=0.584，r=-0.542，P<.01）。此外，L 测试与 RLPT 和 LLPT 之间呈弱正相关（r=0.394，r=0.335，P<.01）。回归模型显示，L 测试与 RLRT、LLRT 和 TGT 相关（R=0.432，P<.001）。L 测试能力越高，与 TGT 水平越高呈弱相关（标准化β=-0.28，P=.0012）。此外，回归分析还证明 F8WT 与 RLRT、LLRT 和 TGT 相关（R=0.522，P<.001）。最相关的参数是 LLRT（标准化β=0.958，P=.003）。
形状路径中的步态与 TKA 老年患者的本体感觉、反应时间和平衡能力有关。因此，应考虑本体感觉、反应时间和平衡能力，以改善双侧、右侧或左侧 TKA 手术后患者在形状路径中的行走能力。
