Yoshikawa Ryo, Kanzaki Noriyuki, Matsuno Ryoma, Saho Wataru, Kashima Ryoga, Harada Risa, Kuroda Ryosuke, Sakai Yoshitada
Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, JPN.
Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, JPN.
Cureus. 2025 Feb 2;17(2):e78392. doi: 10.7759/cureus.78392. eCollection 2025 Feb.
Objectives Total ankle arthroplasty (TAA) is increasingly performed to alleviate pain and improve function in patients with end-stage ankle osteoarthritis. This study aimed to evaluate the gait characteristics of patients with TAA using a motion sensor-based system and to investigate the relationship between postoperative pain and gait parameters. Methods This cross-sectional study included patients at least three months post-TAA. The evaluated parameters included sex, age, postoperative period, and the dorsiflexion/plantarflexion range of motion (ROM) of the ankle. Gait analysis was performed using a six-axis inertial sensor attached to both shoes to measure stride speed, heel-strike angle, toe-off angle (TOA), pronation angle, foot progression angle, vertical height, swing width, and stride length normalized to height. Pain was assessed using the Self-Administered Foot Evaluation Questionnaire (SAFE-Q). Comparisons were made between the surgical and contralateral sides, and the correlations between pain scores and measured angles were examined. Results Thirty-eight patients (mean age: 76 ± 5 years) were evaluated. The surgical side demonstrated significantly lower TOA (48.9° vs. 59.0°) and plantarflexion ROM (35.5° vs. 49.6°) compared with the contralateral side (p < 0.001). Although the pain scores showed no correlation with ROM, TOA on the surgical side showed a positive correlation with pain scores (r = 0.379, p < 0.05). Conclusions The surgical side exhibited reduced plantarflexion ROM and smaller TOA compared with the contralateral side. Additionally, greater postoperative pain was associated with lower TOA on the surgical side. Therefore, motion sensor-based gait analysis can be a valuable tool for tailoring rehabilitation strategies and improving outcomes following TAA.
目的 全踝关节置换术（TAA）越来越多地用于缓解终末期踝关节骨关节炎患者的疼痛并改善其功能。本研究旨在使用基于运动传感器的系统评估TAA患者的步态特征，并探讨术后疼痛与步态参数之间的关系。方法 这项横断面研究纳入了TAA术后至少三个月的患者。评估参数包括性别、年龄、术后时间以及踝关节背屈/跖屈活动范围（ROM）。使用附着在双鞋上的六轴惯性传感器进行步态分析，以测量步速、足跟触地角度、离地角度（TOA）、内旋角度、足前进角度、垂直高度、摆动宽度以及根据身高标准化的步长。使用自我管理足部评估问卷（SAFE-Q）评估疼痛。对手术侧和对侧进行比较，并检查疼痛评分与测量角度之间的相关性。结果 对38例患者（平均年龄：76±5岁）进行了评估。与对侧相比，手术侧的TOA（48.9°对59.0°）和跖屈ROM（35.5°对49.6°）明显更低（p<0.001）。尽管疼痛评分与ROM无相关性，但手术侧的TOA与疼痛评分呈正相关（r = 0.379，p<0.05）。结论 与对侧相比，手术侧的跖屈ROM减小，TOA更小。此外，术后疼痛加剧与手术侧较低的TOA相关。因此，基于运动传感器的步态分析可以成为制定康复策略和改善TAA术后疗效的有价值工具。
