Okazawa Kazuya, Hamai Satoshi, Fujita Tsutomu, Nasu Yuki, Kawahara Shinya, Nakashima Yasuharu, Ishikawa Hitoshi, Fujii Hiromi, Katoh Hiroshi
Department of Rehabilitation, Kyushu University Hospital, Fukuoka 812-8582, Japan.
Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, Yamagata 990-2212, Japan.
Life (Basel). 2025 May 11;15(5):768. doi: 10.3390/life15050768.
The aging population in Japan has led to an increase in traffic accidents involving elderly drivers, highlighting the need for measures to enhance driving safety. Post-total knee arthroplasty (TKA) patients must regain their driving ability to maintain independence; however, clear guidelines for driving resumption are lacking. This study assessed the movement time (MT) and brake pedal force (BPF) using a driving simulator and investigated their associations with lower limb motor function.
This single-center prospective cohort study included 21 patients (mean age: 66.7 ± 7.4 years) who underwent right TKA and intended to resume driving. Driving ability was assessed on postoperative day 13 using a driving simulator to measure MT and BPF. Physical function was evaluated using the following parameters: range of motion (ROM), muscle strength, gait parameters, and pain assessment. Pearson's correlation and multiple regression analyses were performed to identify significant associations.
MT was significantly correlated with knee extension strength (r = -0.56, = 0.02) and walking ratio (r = 0.55, = 0.03). BPF was significantly correlated with walking ratio (r = 0.52, = 0.04) and pain levels VAS (r = -0.54, = 0.02). Multiple regression analysis identified walking ratio (β = 0.54, = 0.02) as a significant predictor of MT. For BPF, significant predictors included walking ratio (β = 0.49, = 0.03) and VAS (β = -0.54, = 0.02).
The findings of this study suggest that MT is associated with walking ratio, while BPF is significantly associated with both walking ratio and VAS scores. In particular, walking ratio was found to have a significant impact on both MT and BPF, indicating that it may be an important factor influencing postoperative driving performance.
Improvement in the walking ratio and pain management affect accelerator and brake operation during driving after TKA.
日本人口老龄化导致涉及老年驾驶员的交通事故增多，凸显了采取措施提高驾驶安全性的必要性。全膝关节置换术（TKA）后患者必须恢复驾驶能力以维持独立性；然而，目前缺乏关于恢复驾驶的明确指南。本研究使用驾驶模拟器评估运动时间（MT）和制动踏板力（BPF），并调查它们与下肢运动功能的关联。
本单中心前瞻性队列研究纳入了21例行右膝TKA且打算恢复驾驶的患者（平均年龄：66.7±7.4岁）。在术后第13天使用驾驶模拟器测量MT和BPF来评估驾驶能力。使用以下参数评估身体功能：活动范围（ROM）、肌肉力量、步态参数和疼痛评估。进行Pearson相关性分析和多元回归分析以确定显著关联。
MT与膝关节伸展力量显著相关（r = -0.56，P = 0.02）和步行比率（r = 0.55，P = 0.03）。BPF与步行比率显著相关（r = 0.52，P = 0.04）和疼痛水平视觉模拟评分（VAS）（r = -0.54，P = 0.02）。多元回归分析确定步行比率（β = 0.54，P = 0.02）是MT的显著预测因子。对于BPF，显著预测因子包括步行比率（β = 0.49，P = 0.03）和VAS（β = -0.54，P = 0.02）。
本研究结果表明MT与步行比率相关，而BPF与步行比率和VAS评分均显著相关。特别是，发现步行比率对MT和BPF均有显著影响，表明它可能是影响术后驾驶性能的重要因素。
步行比率的改善和疼痛管理会影响TKA术后驾驶时的油门和刹车操作。
