The impact of preoperative muscle strength on postoperative walking ability in patients undergoing total knee arthroplasty.

Autor: Terao Y; Department of Rehabilitation Medicine, The Jikei University School of Medicine Hospital.; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo., Hosaka N; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo., Otobe Y; Department of Rehabilitation Science, Physical Therapy Course, School of Medicine, Osaka Metropolitan University, Osaka., Suzuki M; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo., Kojima I; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo., Yoshizawa K; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo., Yamada M; Faculty of Human Sciences, University of Tsukuba., Nakayama Y; Department of Rehabilitation Medicine, The Jikei University School of Medicine Hospital., Abo M; Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Jazyk: angličtina
Zdroj: International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation [Int J Rehabil Res] 2023 Jun 01; Vol. 46 (2), pp. 157-162. Date of Electronic Publication: 2023 Mar 06.
DOI: 10.1097/MRR.0000000000000572
Abstrakt: Although knee extensor muscle strength is strongly associated with postoperative walking ability (PWA) in patients undergoing total knee arthroplasty (TKA), few studies have considered the impact of both knee extensor and flexor muscle strength. This study aimed to determine whether operative side knee flexor and extensor muscle strength before surgery affects the PWA of patients who undergo TKA while accounting for potential covariates. This multicenter retrospective cohort study involved four university hospitals, and patients who underwent unilateral primary TKA were included. The outcome measure was the 5-m maximum walking speed test (MWS), which was completed 12 weeks postoperatively. Muscle strength was measured as the maximum isometric muscle strength required for knee flexor and extensor. Three multiple regression models with a progressively larger number of variables were developed to determine the predictors of 5-m MWS at 12 weeks post-TKA surgery. One hundred thirty-one patients who underwent TKA were enrolled in the study (men, 23.7%; mean age, 73.4 ± 6.9 years). Age, sex, operative side knee flexor muscle strength before surgery, Japanese Orthopaedic Association knee score, and preoperative walking ability were significantly associated with PWA in the final model of the multiple regression analysis ( R2  = 0.35). The current findings suggest that the operative side knee flexor muscle strength before surgery is a robust modifiable predictor of improved PWA. We believe that further validation is needed to determine the causal relationship between preoperative muscle strength and PWA.
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Databáze: MEDLINE
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