Factors characterizing gait performance of patients before and soon after knee arthroplasty

Hideyuki Ito, Kiyoshi Ichihara, Kotaro Tamari, Tetsuya Amano, Shigeharu Tanaka, Shigehiro Uchida, Hideyuki Ito, Kiyoshi Ichihara, Kotaro Tamari, Tetsuya Amano, Shigeharu Tanaka, Shigehiro Uchida

Abstract

[Purpose] For monitoring patients with knee osteoarthritis undergoing knee arthroplasty, the Timed Up and Go and maximum walking speed tests are commonly used. To provide appropriate peri-surgical rehabilitation, we evaluated the factors associated with postsurgical changes in Timed Up and Go and maximum walking speed results. [Participants and Methods] We enrolled 545 knee osteoarthritis patients undergoing either of the following knee arthroplasties: conventional total knee arthroplasty, minimally invasive total knee arthroplasty, and unicompartmental knee arthroplasty. Comfortable Timed Up and Go, maximum Timed Up and Go, and maximum walking speed were measured 2 weeks before and soon after surgery. Factors (gender, age, and surgical mode) that might influence changes in test results were evaluated by multiple regression analysis and a two-factor stratification diagram. [Results] Multiple regression analysis revealed that postsurgical changes in comfortable/maximum Timed Up and Go and maximum walking speed results were associated with age and surgical mode after adjustment for preoperative values. Two-factor diagrams showed that the older the patient, the greater was the slowdown in the Timed Up and Go test performed postoperatively. The levels of slowdown in the postoperative Timed Up and Go and maximum walking speed tests were the smallest in those who underwent conventional total knee arthroplasty, followed by those who underwent minimally invasive and unicompartmental knee arthroplasty. Among patients whose preoperative Timed Up and Go and maximum walking speed were slow, slowdown in Timed Up and Go was pronounced with age, and slowdown in maximum walking speed was higher in conventional total knee arthroplasty. [Conclusion] The changes in Timed Up and Go and maximum walking speed results 2 weeks after knee arthroplasty depended on age and surgical modes. These findings are relevant for the implementation of appropriate peri-surgical rehabilitation.

Keywords: Age-related change; Multiple regression analysis; Surgical mode.

2021©by the Society of Physical Therapy Science. Published by IPEC Inc.

Figures

Fig. 1.
Fig. 1.
Comparison diagram of Timed Up and Go (TUG) between pre- and post-surgery. The measurement values of the comfortable TUG (Fig. 1A) and maximum TUG (Fig. 1B) are compared between pre- and post-surgery. The boxes and the line in the center show the central 50% range and the median for each group.
Fig. 2.
Fig. 2.
Comparison diagram of maximum walking speed (MWS) between pre- and post-surgery. The measurement values of MWS are compared between pre- and post-surgery. The boxes and the line in the center show the central 50% range and the median for each group.
Fig. 3.
Fig. 3.
A stratification diagram by preoperative values and by age vis-à-vis the amount of change in comfortable Timed Up and Go (TUG). The amount of change in the comfortable TUG test is compared by stratifying preoperative values and age. The boxes and the line in the center show the central 50% range and the median for each group. The lines connecting the medians between age subgroups were drawn to visualize the magnitude of changes in values by age.
Fig. 4.
Fig. 4.
Stratification diagram by preoperative values and by operative method vis-à-vis the amount of change in comfortable Timed Up and Go (TUG). The amount of change in the comfortable TUG test is compared by stratifying preoperative values and operative methods. The boxes and the line in the center show the central 50% range and the median for each group. The lines connecting the medians between operative-mode subgroups were drawn to visualize the magnitude of changes in values by operative modes.
Fig. 5.
Fig. 5.
Stratification diagram by preoperative values and by age vis-à-vis the amount of change in maximum Timed Up and Go (TUG). The amount of change in the maximum TUG is compared by stratifying the preoperative values and age. The boxes and the line in the center show the central 50% range and the median for each group. The lines connecting the medians between age subgroups were drawn to visualize the magnitude of changes in values by age.
Fig. 6.
Fig. 6.
Stratification diagram by preoperative values and by operative method vis-à-vis the amount of change in maximum Timed Up and Go (TUG). The amount of change in maximum TUG is compared by stratifying preoperative values and operative methods. The boxes and the line in the center show the central 50% range and the median for each group. The lines connecting the medians between operative-mode subgroups were drawn to visualize the magnitude of changes in values by operative modes.
Fig. 7.
Fig. 7.
Stratification diagram by preoperative values and by age vis-à-vis amount of change in of maximum walking speed (MWS). The amount of change in MWS is compared by stratifying the preoperative values and the and age. The boxes and the line in the center show the central 50% range and the median for each group. The lines connecting the medians between age subgroups were drawn to visualize the magnitude of changes in values by age.
Fig. 8.
Fig. 8.
Stratification diagram by preoperative values and by operative mode vis-à-vis amount of change in of maximum walking speed (MWS). The amount of change in MWS is compared by stratifying the preoperative values and the operative method. The boxes and the line in the center show the central 50% range and the median for each group. The lines connecting the medians between operative-mode subgroups were drawn to visualize the magnitude of changes in values by operative modes.

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