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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

Plot of the first two canonical discriminant functions. Discriminant function 1 discriminates between TKA patients (groups 1 to 3) and healthy age matched controls (group 7). Discriminant function 2 discriminates between 8 week post-op patients (group 2) and 52 week post-op patients (group 3).
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Fig3: Plot of the first two canonical discriminant functions. Discriminant function 1 discriminates between TKA patients (groups 1 to 3) and healthy age matched controls (group 7). Discriminant function 2 discriminates between 8 week post-op patients (group 2) and 52 week post-op patients (group 3).

Mentions: The discriminant functions are described in detail in Appendix A. A plot of discriminant functions 1 and 2 for all groups is shown in Figure 3. This shows that the first function discriminates the patient groups (1 to 3) from the control group (7). The controls have higher positive values on discriminant function 1, and knee_stance notably has the highest load (0.791) on discriminant function 1, indicating that this is the most important differentiator between the patients and controls. Thigh range has only a small load on this function (0.033), indicating that it is the least important discriminator between the controls and patient groups. Dimension 2 discriminates patient group 2 and 3. Patients group 2 have higher positive values on discriminant function 2. Knee_swing has the highest loading on discriminant function 2 (−1.018), indicating that it is the most important discriminator between patient group 2 and 3; the next most important factor is knee_stance with a loading of 0.526. For both discriminant factors, ave_dur had relatively low loading.Figure 3


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)

Plot of the first two canonical discriminant functions. Discriminant function 1 discriminates between TKA patients (groups 1 to 3) and healthy age matched controls (group 7). Discriminant function 2 discriminates between 8 week post-op patients (group 2) and 52 week post-op patients (group 3).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig3: Plot of the first two canonical discriminant functions. Discriminant function 1 discriminates between TKA patients (groups 1 to 3) and healthy age matched controls (group 7). Discriminant function 2 discriminates between 8 week post-op patients (group 2) and 52 week post-op patients (group 3).
Mentions: The discriminant functions are described in detail in Appendix A. A plot of discriminant functions 1 and 2 for all groups is shown in Figure 3. This shows that the first function discriminates the patient groups (1 to 3) from the control group (7). The controls have higher positive values on discriminant function 1, and knee_stance notably has the highest load (0.791) on discriminant function 1, indicating that this is the most important differentiator between the patients and controls. Thigh range has only a small load on this function (0.033), indicating that it is the least important discriminator between the controls and patient groups. Dimension 2 discriminates patient group 2 and 3. Patients group 2 have higher positive values on discriminant function 2. Knee_swing has the highest loading on discriminant function 2 (−1.018), indicating that it is the most important discriminator between patient group 2 and 3; the next most important factor is knee_stance with a loading of 0.526. For both discriminant factors, ave_dur had relatively low loading.Figure 3

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