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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

Box plots for knee range of motion during stance and swing for controls, pre-op patients and post-op patients. MANOVA showed that these two variables were the most significant in assessing the effects of surgery, and comparing patients with control.
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Fig4: Box plots for knee range of motion during stance and swing for controls, pre-op patients and post-op patients. MANOVA showed that these two variables were the most significant in assessing the effects of surgery, and comparing patients with control.

Mentions: As discriminant analysis has shown that knee_stance and knee_swing are the most significant variables when comparing all the groups, dot plots for knee_ swing and knee_stance are shown in Figure 4, for the controls, pre-op patients, and patients 52 weeks post-operatively. It can be seen that there is more overlap between knee_stance values in controls and post-op patients than for controls and pre-op patients. Only 1/29 pre-op patients were within the normal range, whereas 9/28 patients were within the normal range at 52 weeks (χ2 = 5.83).Figure 4


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)

Box plots for knee range of motion during stance and swing for controls, pre-op patients and post-op patients. MANOVA showed that these two variables were the most significant in assessing the effects of surgery, and comparing patients with control.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig4: Box plots for knee range of motion during stance and swing for controls, pre-op patients and post-op patients. MANOVA showed that these two variables were the most significant in assessing the effects of surgery, and comparing patients with control.
Mentions: As discriminant analysis has shown that knee_stance and knee_swing are the most significant variables when comparing all the groups, dot plots for knee_ swing and knee_stance are shown in Figure 4, for the controls, pre-op patients, and patients 52 weeks post-operatively. It can be seen that there is more overlap between knee_stance values in controls and post-op patients than for controls and pre-op patients. Only 1/29 pre-op patients were within the normal range, whereas 9/28 patients were within the normal range at 52 weeks (χ2 = 5.83).Figure 4

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