The Relationship Between Effort Gait and Physical Function After Total Knee Arthroplasty

Takahiro Yamanari, Takashi Kawamura, Tatsuya Yasukawa, Takatomo Mine, Ryutaro Kuriyama
Purpose:

The aim of this study was to examine the relationship between walking and physical function in patients who could walk independently without assistive devices within three weeks postoperatively and to contribute to the content of postoperative physiotherapy.

Methods:

The subjects were 14 patients (mean age 74.1 years) who were hospitalized for TKA between April 2023 and the end of June 2024, were able to walk independently within three weeks postoperatively, and whose physical function was evaluated. Patients who underwent bilateral TKA on the same day, those who had previously undergone unilateral TKA, or those who could not be evaluated pre- or postoperatively were excluded. Walking sway was measured during effortful walking over a flat 16-meter straight path. Accelerometers (Microstone Corp.) were placed on the thoracic spine and sacral region to record the data. The root mean square (RMS), indicating the magnitude of sway, was calculated in three directions for stance on the operated and non-operated sides, as well as for anterior-posterior and vertical sway. To assess the relative sway between the thoracic and sacral regions, the sacral-to-thoracic ratio (S/T ratio) was calculated by dividing the sacral data by the thoracic data for each direction. Physical function was evaluated by measuring hip abduction strength (hip abductors) and knee extension strength on both the operated and non-operated sides (in kgf/kg), as well as pain using the Numerical Rating Scale (NRS). Correlations between the data from each parameter were analyzed using R Commander.

Results:

A correlation was observed between non-operated side S/T sway and NRS, between upper S/T sway and non-operated hip abduction strength, and between posterior S/T sway and operated knee extension strength.

Conclusion(s):

It is believed that trunk sway increases due to pain avoidance and decreased knee extension strength, and that hip abductors play a role in controlling trunk sway.

Implications:

The findings suggest the need for rehabilitation focused on pain management, hip abductors, and knee extension muscles.

Funding acknowledgements:
unfunded
Keywords:
Total Knee Arthroplasty
Gait
Physical Function
Primary topic:
Disability and rehabilitation
Second topic:
Musculoskeletal: lower limb
Third topic:
Orthopaedics
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Kanmon Medical Center IRB Committee
Provide the ethics approval number:
R0205-1
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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