The importance to including objective functional outcomes in the clinical follow up of total knee arthroplasty patients
The importance to including objective functional outcomes in the clinical follow up of total knee arthroplasty patients
复制标题
DOI：
10.1016/j.knee.2010.07.008
复制
发表时间：
2011-10-01
期刊：
影响因子：
1.9
通讯作者：
Heyligers, Ide C.
中科院分区：
文献类型：
--
作者：
Senden, Rachel;Grimm, Bernd;Heyligers, Ide C.
在临床实践中，定期、客观地评估患者的日常功能变得越来越重要。基于加速度的步态分析 (AGA) 已被证明是可靠的，并且在技术上适合实验室外的常规临床使用。本研究通过调查 (a) AGA 区分患者与健康受试者的能力，(b) AGA 在评估亚群全膝关节置换术后恢复情况时对步态变化的敏感性，以及 (c) AGA 参数与临床量表之间的相关性，研究了 AGA 用于测量拟行全膝关节置换术 (TKA) 的症状性膝关节病骨科患者功能的适用性。使用 AGA 对 24 名接受 TKA 治疗的症状性膝关节病患者和 24 名健康受试者进行步态评估。 AGA 参数（例如速度、不对称性）和临床量表（例如 KSS）用于监测 12 名患者 TKA 后 3 个月的进展情况。进行了 Mann-Whitney-U 检验、受试者工作特征 (ROC) 曲线、重复测量方差分析和皮尔逊相关性。 AGA 将病理步态与健康步态区分开来。 ROC 曲线下面积、速度、步频和步长的灵敏度和特异性值较高。发现了不同的恢复情况，临床量表显示出更快的恢复率。 AGA 和临床评分之间没有发现或只有微弱的相关性。人们发现 AGA 在骨科实践中识别和监测有症状的膝关节病患者方面具有临床相关性，可提供临床范围之外的有关功能的客观和附加信息。这一点，再加上 AGA 可以常规应用的事实，表明 AGA 适合在康复计划中使用。 (C) 2010 Elsevier B.V. 保留所有权利。
In clinical practice, it is increasingly important to assess patients' daily functionality routinely and objectively. Acceleration-based gait analysis (AGA) has shown to be reliable and technically suitable for routine clinical use outside the laboratory. This study investigated the suitability of AGA for measuring function in orthopaedic patients with symptomatic gonarthrosis listed for total knee arthroplasty (TKA) by investigating (a) the ability of AGA to distinguish patients from healthy subjects, (b) the sensitivity to gait changes of AGA in assessing recovery following total knee arthroplasty in a subpopulation, and (c) correlations between AGA parameters and clinical scales. Gait was assessed using AGA in 24 patients with symptomatic gonarthrosis listed for TKA, and in 24 healthy subjects. AGA parameters (e.g. speed, asymmetry) and clinical scales (e.g. KSS) were used to monitor progress in 12 patients 3 months after TKA. The Mann-Whitney-U test, Receiver Operating Characteristic (ROC) curves, repeated measurement ANOVA and Pearson correlations were performed. AGA differentiated pathological from healthy gait. The area under the ROC curve, sensitivity and specificity values were high for speed, step frequency and step length. Different recovery profiles were found, with clinical scales showing faster recovery rates. None or only weak correlations were found between AGA and clinical scores. AGA was found to be of clinical relevance in identifying and monitoring patients with symptomatic gonarthrosis in orthopaedic practice, providing objective and additional information about function beyond clinical scales. This, together with the fact that AGA can be applied routinely, suggests the suitability of AGA for use in rehabilitation programs. (C) 2010 Elsevier B.V. All rights reserved.