| 소속 |
Jeju National University School of Medicine, Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju, Repubic of Korea, Department of Rehabilitation Medicine1, Jeju National University School of Medicine, Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University Hospital, Jeju, Repubic of Korea, Department of Orthopedic Surgery2 |
Objective: This study was undertaken to determine the factors correlated with postoperative walking speed and distance at 3 month after unilateral total knee arthroplasty (TKA).
Methods: Cross-sectional data from 149 patients (23 males and 126 females; average age 72.1 ± 6.4 years) who underwent unilateral primary TKA were analyzed. The instrumental gait analysis for spatio-temporal parameters, isometric knee extensor and flexor strength of both knees, 6 minute walk test (6MWT), timed up-and-go (TUG) test, timed stair climbing test (SCT), knee flexion and extension range of motion (ROM) of surgical knee, Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) pain, stiffness, and functional levels, EuroQol five-dimensions (EQ-5D) questionnaire were assessed.
Results: In bivariate analyses, postoperative walking speed had significant positive correlations with cadence (r=0.35, p<0.001), stride length (r=0.66, p<0.001), propulsion index of surgical (r=0.48, p<0.001) and non-surgical knee (r=0.57, p<0.001), peak torque (PT) of the extensor of surgical (r=0.29, p<0.001) and non-surgical knee (r=0.24, p=0.003) and flexor of surgical (r=0.19, p=0.019) and non-surgical knee (r=0.19, p=0.021), 6MWT (r=0.41, p<0.001), EQ-5D (r=0.35, p<0.001), and significant negative correlation with gait cycle duration (r=-0.29, p<0.001), TUG (r=-0.51, p<0.001), SCT-ascent (r=-0.33, p<0.001) and decent (r=-0.42, p<0.001) and WOMAC pain levels (r=-0.16, p=0.048). The postoperative walking distance had significant positive correlation with walking speed (r=0.41, p<0.001), cadence (r=0.20, p=0.015), stride length (r=0.30, p<0.001), swing phase duration (r=0.17, p=0.034), propulsion index of surgical (r=0.43, p<0.001) and non-surgical knee (r=0.38, p<0.001), PT of the extensor of surgical (r=0.22, p=0.009) and non-surgical knee (r=0.17, p=0.035), EQ-5D (r=0.34, p<0.001), and significant negative correlation with gait cycle duration (r=-0.22, p=0.007), double support duration (r=-0.19, p=0.021), TUG (r=-0.64, p<0.001), SCT-ascent (r=-0.62, p<0.001), decent (r=-0.42, p<0.001) and VAS of both knees (r=-0.30, p<0.001). In the multivariate linear regression analyses adjusted the age and sex variables, TUG (β=-0.023, p=0.002), cadence (β=0.003, p=0.007), stride length (β=0.006, p<0.001) and propulsion index of non-surgical knee (β=0.020, p<0.001) were factor correlated with postoperative walking speed. The SCT-ascent (β=-5.404, p=0.031) and descent (β=-5.881, p=0.018), TUG (β=-13.958, p=0.002) and propulsion index of surgical knee (β=7.767, p=0.006) were factor correlated with postoperative walking distance.
Conclusion: This study confirmed the performance-based physical function were important factors with walking speed and distance 3 month after TKA. |
