Long-term data of gait characteristics and moment–knee angle relations in female total knee arthroplasty patients

Ullrich, Boris; Stening, Jens; Pelzer, Thiemo; Raab, Jana

doi:10.1016/j.clinbiomech.2015.03.009

Cited by 5 publications

(6 citation statements)

References 43 publications

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“… 1 , 2 Although TKA can lead to decreased pain, increased knee range of motion (ROM), and eventually, improved physical function and quality of life (QOL), 3 physical function (e.g., quadriceps and hamstring strength, and knee ROM) decreases immediately after TKA. 4 , 5 A stiff knee gait (SKG), in which there is reduced knee flexion during walking, 6 , 7 increases energy cost and decreases walking speed. 8 It has previously been revealed that there is a temporary postoperative decrease in walking ability, including walking speed, followed by a recovery time of several months to 1 year.…”

Section: Introductionmentioning

confidence: 99%

Gait Training Using a Hip-Wearable Robotic Exoskeleton After Total Knee Arthroplasty: A Case Report

Koseki

Mutsuzaki

Yoshikawa

et al. 2020

Geriatr Orthop Surg Rehabil

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The Honda Walking Assist® (HWA) is a light and easy wearable robot device for gait training, which assists patients’ hip flexion and extension movements to guide hip joint movements during gait. However, the safety and feasibility of gait training with HWA after total knee arthroplasty (TKA) remains unclear. Thus, we aimed to evaluate the safety and feasibility of this gait training intervention using HWA for a patient who underwent TKA. The patient was a 76-year-old female who underwent a left TKA. Gait training using HWA was conducted for 18 sessions in total, from 1 to 5 weeks after TKA. To verify the recovery process after TKA surgery, knee function parameters and walking ability were measured at pre-TKA and 1, 2, 4, and 8 weeks after TKA. The gait patterns at self-selected walking speed (SWS) without HWA at pre- and 5 weeks after TKA were measured by using 3-dimensional (3D) gait analysis. The patient completed a total of 18 gait training interventions with HWA without any adverse complications such as knee pain and skin injury. The postoperative knee extension range of motion (ROM), knee extension torque, SWS, and maximum walking speed were remarkably improved. Regarding gait kinematic parameters, though this patient had a characteristic gait pattern with decreased knee ROM (called stiff knee gait) preoperatively, the knee flexion angle at 5 weeks after TKA showed knee flexion movement at loading response phase (LR; called double knee action), increased knee ROM during gait, and increased knee flexion angle at swing phase. In this case, the gait training using HWA was safe and feasible, and could be effective for the early improvement of gait ability, hip function, and gait pattern after TKA.

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Section: Introductionmentioning

confidence: 99%

Gait Training Using a Hip-Wearable Robotic Exoskeleton After Total Knee Arthroplasty: A Case Report

Koseki

Mutsuzaki

Yoshikawa

et al. 2020

Geriatr Orthop Surg Rehabil

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“…Potential mechanisms of functional ambulation improvement following strength training might be explained by neuromuscular reactivation. Patients following KR may exhibit quadricep weakness and atrophy resulting from long-term KOA and the surgery, which can further lead to persistent neuromuscular activation deficits 6 , 54 . Such deficits can limit the ability to generate force and result in poor physical functions 6 .…”

Section: Discussionmentioning

confidence: 99%

Effects of strength training on functional ambulation following knee replacement: a systematic review, meta-analysis, and meta-regression

Wang

Zhu

et al. 2023

Sci Rep

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Strength training is recommended by the American Physical Therapy Association to improve muscle strength, mobility, and balance following knee replacement. Few studies have focused on the direct effects of strength training on functional ambulation, and potential dose–response relationships between strength training parameters and the effect remain unclear. The aim of this systematic review, meta-analysis, and meta-regression was to evaluate the effects of strength training on functional ambulation following knee replacement (KR). We also aimed to explore potential dose–response relationships between strength training parameters and performance in functional ambulation. A systematic literature search of eight online databases was performed on March 12, 2023, for randomized controlled trials evaluating the effects of strength training on functional ambulation by six-minute walk test (6MWT) or timed-up and go test (TUG) after KR. Data were pooled by random-effect meta-analyses and presented as weighted mean difference (WMD). A random-effect meta-regression was performed for four predetermined training parameters, namely, duration (weeks), frequency (sessions per week), volume (time per session), and initial time (after surgery) separately to explore dose–response relationships with WMD. Fourteen trials encompassing 956 participants were included in our study. Meta-analyses showed an improvement in 6MWT performance after strength training (WMD: 32.15, 95% CI 19.44–44.85) and a decrease in time to complete TUG (WMD: − 1.92, 95% CI − 3.43 to − 0.41). Meta-regression revealed a dose–response relationship only between volume and 6MWT, with a decreasing trend (P = 0.019, 95% CI − 1.63 to − 0.20). Increasing trends of improvement in 6MWT and TUG were observed with increasing training duration and frequency. A slight decreasing trend of improvement was observed in 6MWT with postponed initial time, while an opposite trend was observed in TUG. Based on existing studies, moderate-certainty evidence suggests that strength training could increase 6MWT distance, and low-certainty evidence shows that strength training could decrease the time to complete TUG after KR. Meta-regression results only suggested a dose–response relationship between volume and 6MWT with a decreasing trend.Registration: PROSPERO: CRD42022329006.

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“…Benedetti (2003) suggested that many patients do not regain normal joint function following TKA even during low-level activities such as walking [18]. Even years post-operatively, patients exhibit slower gait, decreased stride length, and abnormal flexion/extension moments particularly during the stance and swing phases [11,17,18].…”

Section: Discussionmentioning

confidence: 99%

“…Typically, kinematic analyses are carried out within gait laboratories and require specialist equipment such as force plates and 3-dimensional motion capture systems. Such systems can uncover detailed information about movement kinetics and kinematics [11] but are hugely expensive and difficult to access in routine orthopaedic clinical practice. Distinct mechanical patterns associated with knee replacement instability have been demonstrated using a simple loaded extension of the knee [12].…”

Section: Introductionmentioning

confidence: 99%

The use of pedobarographic analysis to evaluate movement patterns in unstable total knee arthroplasty: A proof of concept study

et al. 2021

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Long-term data of gait characteristics and moment–knee angle relations in female total knee arthroplasty patients

Cited by 5 publications

References 43 publications

Gait Training Using a Hip-Wearable Robotic Exoskeleton After Total Knee Arthroplasty: A Case Report

Gait Training Using a Hip-Wearable Robotic Exoskeleton After Total Knee Arthroplasty: A Case Report

Effects of strength training on functional ambulation following knee replacement: a systematic review, meta-analysis, and meta-regression

The use of pedobarographic analysis to evaluate movement patterns in unstable total knee arthroplasty: A proof of concept study

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