Quadriceps strength and the time course of functional recovery after total knee arthroplasty
Quadriceps strength and the time course of functional recovery after total knee arthroplasty
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DOI：
10.2519/jospt.2005.35.7.424
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发表时间：
2005-07-01
影响因子：
6.1
通讯作者：
Snyder-Mackler, L
中科院分区：
文献类型：
--
作者：
Mizner, RL;Petterson, SC;Snyder-Mackler, L
研究设计：重复测量的前瞻性研究。目的：本研究的总体目标是描述全膝关节置换术（TKA）后损伤和功能恢复的时间过程，并为康复工作提供指导。我们假设股四头肌力量与功能表现的相关性比TKA前后的膝关节屈曲活动范围（ROM）或疼痛更强。背景：TKA是一种非常常见的手术，但对这一人群中损伤对功能限制的影响知之甚少。方法和测量：研究了40例接受单侧TKA后进行康复治疗（包括6周门诊物理治疗）的受试者。在5个时间段进行测试：术前，术后1、2、3和6个月。测试措施包括股四头肌力量，膝关节ROM，定时上升和去测试，定时爬楼梯测试，身体疼痛，一般健康和膝关节功能questionnaire.Results：受试者经历了显着恶化的膝关节ROM，股四头肌力量，功能测试1个月后手术。股四头肌的力量经历了最大的下降，所有的物理措施评估，从来没有匹配的力量，无关的肢体。在1个月的测试后，所有措施都有显著改善。股四头肌强度是最高度相关的措施与功能性能在所有testing sessions.Conclusions：功能措施进行了预期的下降后，TKA早期，但恢复比预期的更快，长期的结果比以前在文献中报道的更好。股四头肌强度与功能表现之间的高度相关性表明，改善术后股四头肌强度对于增强TKA的潜在受益可能很重要。
Study Design: Prospective study with repeated measures. Objectives: The overall goal of this investigation was to describe the time course of recovery of impairments and function after total knee arthroplasty (TKA), as well as to provide direction for rehabilitation efforts. We hypothesized that quadriceps strength would be more strongly correlated with functional performance than knee flexion range of motion (ROM) or pain at all time periods studied before and after TKA.Background: TKA is a very common surgery, but very little is known regarding the influence of impairments on functional limitations in this population.Methods and Measures: Forty subjects who underwent unilateral TKA followed by rehabilitation, including 6 weeks of outpatient physical therapy, were studied. Testing occurred at 5 time periods: preoperatively, and at 1, 2, 3, and 6 months after surgery. Test measures included quadriceps strength, knee ROM, timed up-and-go test, timed stair-climbing test, bodily pain, and general health and knee function questionnaires.Results: Subjects experienced significant worsening of knee ROM, quadriceps strength, and performance on functional tests 1 month after surgery. Quadriceps strength went through the greatest decline of all the physical measures assessed and never matched the strength of the uninvolved limb. All measures underwent significant improvements following the 1-month test. Quadriceps strength was the most highly correlated measure associated with functional performance at all testing sessions.Conclusions: Functional measures underwent an expected decline early after TKA, but recovery was more rapid than anticipated and long-term outcomes were better than previously reported in the literature. The high correlation between quadriceps strength and functional performance suggests that improved postoperative quadriceps strengthening could be important to enhance the potential benefits of TKA.