Knee Flexion and Daily Activities in Patients following Total Knee Replacement: A Comparison with ISO Standard 14243.
Knee Flexion and Daily Activities in Patients following Total Knee Replacement: A Comparison with ISO Standard 14243.
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DOI：
10.1155/2015/157541
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发表时间：
2015
影响因子：
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通讯作者：
Moisio KC
中科院分区：
文献类型：
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作者：
Wimmer MA;Nechtow W;Schwenke T;Moisio KC
步行只是全膝关节置换术（TKR）后患者进行的许多日常活动之一。本研究的目的是检查以下假设：（a）受试者活动特征与膝关节屈曲活动范围（ROM）相关;（B）受试者全天的屈曲/伸展偏移与ISO规定的膝关节磨损测试输入之间存在显著差异。为了表征活动，收集了32名TKR受试者在日常活动期间的步行和爬楼梯周期数、动态和静止活动所花费的时间、活动序列数和膝关节屈曲/伸展偏移。使用水平交叉分类算法将扩展/扩展配置文件与ISO 14243模拟器输入配置文件进行比较。受试者平均进行了3102次（范围：343-5857）步行循环，包括65次（范围：0-319）楼梯踏步循环。主动和被动ROM与楼梯行走时间、楼梯步数和楼梯行走顺序呈正相关。根据ISO进行的模拟膝关节运动显示，屈曲角度20-40°和超过50°时的水平交叉明显少于使用监测仪测量的水平交叉。这表明植入物磨损测试方案应包含更多周期和各种需要更高膝关节屈曲角度的活动，并包含休息/过渡期，以考虑许多活动序列。
Walking is only one of many daily activities performed by patients following total knee replacement (TKR). The purpose of this study was to examine the hypotheses (a) that subject activity characteristics are correlated with knee flexion range of motion (ROM) and (b) that there is a significant difference between the subject's flexion/extension excursion throughout the day and the ISO specified input for knee wear testing. In order to characterize activity, the number of walking and stair stepping cycles, the time spent with dynamic and stationary activities, the number of activity sequences, and the knee flexion/extension excursion of 32 TKR subjects were collected during daily activity. Flexion/extension profiles were compared with the ISO 14243 simulator input profile using a level crossing classification algorithm. Subjects took an average of 3102 (range: 343–5857) walking cycles including 65 (range: 0–319) stair stepping cycles. Active and passive ROMs were positively correlated with stair walking time, stair step counts, and stair walking sequences. Simulated knee motion according to ISO showed significantly fewer level crossings at the flexion angles 20–40° and beyond 50° than those measured with the monitor. This suggests that implant wear testing protocols should contain more cycles and a variety of activities requiring higher knee flexion angles with incorporated resting/transition periods to account for the many activity sequences.