全膝关节置换术患者术前肌力对术后行走能力的影响。

IF 1.5 4区 医学 Q3 REHABILITATION International Journal of Rehabilitation Research Pub Date : 2023-06-01 DOI:10.1097/MRR.0000000000000572
Yusuke Terao, Naoki Hosaka, Yuhei Otobe, Mizue Suzuki, Iwao Kojima, Kazuya Yoshizawa, Minoru Yamada, Yasuhide Nakayama, Masahiro Abo
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引用次数: 0

摘要

虽然膝关节伸肌力量与全膝关节置换术(TKA)患者术后行走能力(PWA)密切相关,但很少有研究考虑膝关节伸肌和屈肌力量的影响。本研究旨在确定术前手术侧膝关节屈肌和伸肌力量是否会影响TKA患者的PWA,同时考虑潜在的协变量。这项多中心回顾性队列研究涉及四所大学医院,并纳入了单侧原发性TKA患者。结果测量为5米最大步行速度测试(MWS),于术后12周完成。肌肉力量测量为膝关节屈肌和伸肌所需的最大等距肌肉力量。开发了三个变量数量逐渐增加的多元回归模型,以确定tka手术后12周5-m MWS的预测因子。131例接受TKA的患者入组研究(男性,23.7%;平均年龄73.4±6.9岁)。在多元回归分析的最终模型中,年龄、性别、术前侧膝关节屈肌力量、日本骨科协会膝关节评分、术前行走能力与PWA有显著相关(R2 = 0.35)。目前的研究结果表明,术前手术侧膝关节屈肌力量是改善PWA的一个可靠的可修改的预测指标。我们认为术前肌力与PWA之间的因果关系需要进一步的验证。
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The impact of preoperative muscle strength on postoperative walking ability in patients undergoing total knee arthroplasty.

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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来源期刊
CiteScore
3.10
自引率
0.00%
发文量
88
审稿时长
6-12 weeks
期刊介绍: International Journal of Rehabilitation Research is a quarterly, peer-reviewed, interdisciplinary forum for the publication of research into functioning, disability and contextual factors experienced by persons of all ages in both developed and developing societies. The wealth of information offered makes the journal a valuable resource for researchers, practitioners, and administrators in such fields as rehabilitation medicine, outcome measurement nursing, social and vocational rehabilitation/case management, return to work, special education, social policy, social work and social welfare, sociology, psychology, psychiatry assistive technology and environmental factors/disability. Areas of interest include functioning and disablement throughout the life cycle; rehabilitation programmes for persons with physical, sensory, mental and developmental disabilities; measurement of functioning and disability; special education and vocational rehabilitation; equipment access and transportation; information technology; independent living; consumer, legal, economic and sociopolitical aspects of functioning, disability and contextual factors.
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