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Gait assessment as a functional outcome measure in total knee arthroplasty: a cross-sectional study.

Rahman J, Tang Q, Monda M, Miles J, McCarthy I - BMC Musculoskelet Disord (2015)

Bottom Line: The gait of TKA patients as a group was only slightly improved at 12 months when compared with the pre-operative group, and both groups were significantly different to controls in several variables.Even after 12 months after surgery, many TKA patients have not improved their gait relative to pre-operative patients.Routine gait assessment may be used to guide post-operative rehabilitation, and to develop strategies to improve mobility of these patients.

View Article: PubMed Central - PubMed

Affiliation: UCL Institute of Orthopaedics and Musculoskeletal Science, London, UK. jeeshanr@me.com.

ABSTRACT

Background: The aim of the study was to assess gait in total knee arthroplasty (TKA) patients, using a technique that can to be used on a routine basis in a busy orthopaedic clinic.

Methods: A total of 103 subjects were recruited: 29 pre-op TKA patients; 17 TKA patients at 8 weeks post-op; 28 TKA patients at 52 weeks post-op; and 29 age-matched controls. Inertial measurement units (IMUs) were used to assess gait. Limb segment angles, knee angle and temporal parameters of gait were calculated. Specific gait parameters were quantified, and data analysed using MANOVA and discriminant analysis.

Results: The gait of TKA patients as a group was only slightly improved at 12 months when compared with the pre-operative group, and both groups were significantly different to controls in several variables. Knee flexion range in stance was the most important variable in discriminating between patients and controls; knee flexion range in swing was the only variable that showed a significant difference between pre- and post-operative patients. When considered individually, only 1/29 patient was within the normal range for this variable pre-operatively, but 9/28 patients were within the normal range 12 months post-operatively.

Conclusions: Even after 12 months after surgery, many TKA patients have not improved their gait relative to pre-operative patients. Routine gait assessment may be used to guide post-operative rehabilitation, and to develop strategies to improve mobility of these patients.

No MeSH data available.


Related in: MedlinePlus

Positioning of the IMUs using Velcro straps on each thigh and shank. The straps could be applied outside clothing.
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Fig1: Positioning of the IMUs using Velcro straps on each thigh and shank. The straps could be applied outside clothing.

Mentions: Motion sensors (GaitSmart, ETB, UK) were attached by Velcro straps, one to each thigh and shank (as shown in Figure 1); the sensors comprise three tri-axial accelerometers and three tri-axial gyroscopes. The thigh sensors were attached along the saggital plane of the thigh over the lateral aspect approximately 10 cm above the lateral joint line. The shank sensors were likewise attached over the widest part of the calf muscle taking different patient heights into consideration. Patients were then asked to walk for 10 metres along a corridor, turn round, and then walk 10 metres back. The sensors were then removed, and data downloaded to computer for calculation of thigh and shank sagittal and coronal angles, knee sagittal angles, and temporal descriptors of gait. A number of discrete parameters were then extracted from the data for a typical stride, and after preliminary inspection of the data, the following were selected for detailed analysis: knee range of motion during swing (knee_swing) and stance (knee_stance) phases; overall thigh sagittal ROM (thigh_sag); overall shank sagittal ROM (shank_sag); coronal thigh ROM (thigh_cor); coronal shank ROM (shank_cor); the difference in timing between the two peaks of thigh sagittal angle (t_p_diff); and stride duration (ave_dur). Oxford Knee Score questionnaires were completed pre-operatively and 52 weeks post-operatively, and passive range of motion was also recorded. Other data collected included: age and gender; medical history including previous surgery on the limbs; the type of prosthesis used in post-operative patients; surgical complications. In addition, 29 age- and gender-matched controls were measured for comparison with the knee arthroplasty patients. Ethical approval for the study was obtained from NRES Committee London City Road and Hampstead (Ref: 12/LO/0038). All participants gave written informed consent.Figure 1


Gait assessment as a functional outcome measure in total knee arthroplasty: a cross-sectional study.

Rahman J, Tang Q, Monda M, Miles J, McCarthy I - BMC Musculoskelet Disord (2015)

Positioning of the IMUs using Velcro straps on each thigh and shank. The straps could be applied outside clothing.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4374376&req=5

Fig1: Positioning of the IMUs using Velcro straps on each thigh and shank. The straps could be applied outside clothing.
Mentions: Motion sensors (GaitSmart, ETB, UK) were attached by Velcro straps, one to each thigh and shank (as shown in Figure 1); the sensors comprise three tri-axial accelerometers and three tri-axial gyroscopes. The thigh sensors were attached along the saggital plane of the thigh over the lateral aspect approximately 10 cm above the lateral joint line. The shank sensors were likewise attached over the widest part of the calf muscle taking different patient heights into consideration. Patients were then asked to walk for 10 metres along a corridor, turn round, and then walk 10 metres back. The sensors were then removed, and data downloaded to computer for calculation of thigh and shank sagittal and coronal angles, knee sagittal angles, and temporal descriptors of gait. A number of discrete parameters were then extracted from the data for a typical stride, and after preliminary inspection of the data, the following were selected for detailed analysis: knee range of motion during swing (knee_swing) and stance (knee_stance) phases; overall thigh sagittal ROM (thigh_sag); overall shank sagittal ROM (shank_sag); coronal thigh ROM (thigh_cor); coronal shank ROM (shank_cor); the difference in timing between the two peaks of thigh sagittal angle (t_p_diff); and stride duration (ave_dur). Oxford Knee Score questionnaires were completed pre-operatively and 52 weeks post-operatively, and passive range of motion was also recorded. Other data collected included: age and gender; medical history including previous surgery on the limbs; the type of prosthesis used in post-operative patients; surgical complications. In addition, 29 age- and gender-matched controls were measured for comparison with the knee arthroplasty patients. Ethical approval for the study was obtained from NRES Committee London City Road and Hampstead (Ref: 12/LO/0038). All participants gave written informed consent.Figure 1

Bottom Line: The gait of TKA patients as a group was only slightly improved at 12 months when compared with the pre-operative group, and both groups were significantly different to controls in several variables.Even after 12 months after surgery, many TKA patients have not improved their gait relative to pre-operative patients.Routine gait assessment may be used to guide post-operative rehabilitation, and to develop strategies to improve mobility of these patients.

View Article: PubMed Central - PubMed

Affiliation: UCL Institute of Orthopaedics and Musculoskeletal Science, London, UK. jeeshanr@me.com.

ABSTRACT

Background: The aim of the study was to assess gait in total knee arthroplasty (TKA) patients, using a technique that can to be used on a routine basis in a busy orthopaedic clinic.

Methods: A total of 103 subjects were recruited: 29 pre-op TKA patients; 17 TKA patients at 8 weeks post-op; 28 TKA patients at 52 weeks post-op; and 29 age-matched controls. Inertial measurement units (IMUs) were used to assess gait. Limb segment angles, knee angle and temporal parameters of gait were calculated. Specific gait parameters were quantified, and data analysed using MANOVA and discriminant analysis.

Results: The gait of TKA patients as a group was only slightly improved at 12 months when compared with the pre-operative group, and both groups were significantly different to controls in several variables. Knee flexion range in stance was the most important variable in discriminating between patients and controls; knee flexion range in swing was the only variable that showed a significant difference between pre- and post-operative patients. When considered individually, only 1/29 patient was within the normal range for this variable pre-operatively, but 9/28 patients were within the normal range 12 months post-operatively.

Conclusions: Even after 12 months after surgery, many TKA patients have not improved their gait relative to pre-operative patients. Routine gait assessment may be used to guide post-operative rehabilitation, and to develop strategies to improve mobility of these patients.

No MeSH data available.


Related in: MedlinePlus