Rate of torque development is the primary contributor to quadriceps avoidance gait following total knee arthroplasty
| Autor: | Brian Noehren, Paul W. Kline, Cale A. Jacobs, Stephen T. Duncan |
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| Rok vydání: | 2019 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Knee Joint medicine.medical_treatment Biophysics Total knee arthroplasty Osteoarthritis Article 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Risk Factors medicine Humans Torque Orthopedics and Sports Medicine Muscle Strength Range of Motion Articular Arthroplasty Replacement Knee Muscle Skeletal Gait Aged Rehabilitation business.industry Excursion 030229 sport sciences Targeted interventions Middle Aged Osteoarthritis Knee musculoskeletal system medicine.disease Knee pain Female medicine.symptom Gait Analysis business human activities 030217 neurology & neurosurgery |
| Zdroj: | Gait & Posture. 68:397-402 |
| ISSN: | 0966-6362 |
| DOI: | 10.1016/j.gaitpost.2018.12.019 |
| Popis: | Background Following rehabilitation for total knee arthroplasty, “quadriceps avoidance gait”, defined by limited knee flexion angle excursion during walking, persists and contributes to poor long-term outcomes. Given the presence of several post-surgical impairments, identifying the contribution of multiple factors to knee flexion angle excursion is important to developing targeted interventions to improve recovery after total knee arthroplasty. Research questions Which outcomes continue to improve following rehabilitation for total knee arthroplasty? What are the primary contributors to impaired knee flexion angle excursion during walking following total knee arthroplasty? Methods Peak muscle strength and rate of torque development of the quadriceps, hip abductors, and hip external rotators, five-time sit-to-stand test, Knee Injury & Osteoarthritis Outcome Score, and gait mechanics were assessed in 24 participants at three and six months post-surgery. Paired sample t-tests or Wilcoxon Signed-Rank tests were used to compare outcomes between assessments. Stepwise multiple linear regression were used to assess the contribution of each measure to knee flexion angle excursion. Results Significant improvements were noted in all outcomes except hip external rotation rate of torque development, gait speed, and knee flexion angle excursion. Quadriceps rate of torque development and knee pain significantly contributed to knee flexion angle excursion at three months (Adjusted R2 = 0.342), while quadriceps rate of torque development and peak hip external rotation strength significantly contributed at six months (Adjusted R2 = 0.436). Significance While higher pain levels at three months and greater peak hip external rotation muscle strength at six months contribute to impaired knee flexion angle excursion, quadriceps rate of torque development was the primary contributor to knee flexion angle excursion at both three and six months after surgery. Implementing strategies to maximize quadriceps rate of torque development during rehabilitation may help to reduce quadriceps avoidance gait after total knee arthroplasty. |
| Databáze: | OpenAIRE |
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