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Zhao R, Wei X, Hu S, Zhang Y, Wu H, Li P, Zhao Y. Deficient gait function despite effect index of the Western Ontario and McMaster university osteoarthritis index score considered cured one year after bilateral total knee arthroplasty. BMC Musculoskelet Disord 2024; 25:230. [PMID: 38521939 PMCID: PMC10960387 DOI: 10.1186/s12891-024-07348-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 03/11/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND To clarify the value of gait analysis and its consistency with traditional scoring scales for the evaluation of knee joint function after total knee arthroplasty (TKA). METHODS This study included 25 patients with knee osteoarthritis (KOA) who underwent bilateral TKA, and 25 conditionally matched healthy individuals, categorised into the experimental and control groups, respectively. Patients in the experimental group underwent gait analysis and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) evaluation before and 1 year after TKA. Weight-bearing balance and walking stability were assessed using discrete trends of relevant gait indicators. Pearson's correlation analysis was performed on the gait and WOMAC score data of the experimental group before and after TKA. RESULTS One year after TKA, patients' gait indices (except gait cycle) were significantly better than before surgery, but significantly worse than that of the control group (P < 0.01). The shape of patients' plantar pressure curves did not return to normal. Additionally, the discrete trend of related gait indicators reflecting weight-bearing balance and walking stability were smaller than before TKA, but still greater than that of the control group. The WOMAC scores of patients 1 year after TKA were significantly lower than those before TKA (P < 0.001), and the efficacy index was > 80%. The WOMAC scores and gait analysis results were significantly correlated before TKA (P < 0.05). CONCLUSIONS Gait analysis should be used in conjunction with scoring scales to assess joint functions.
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Affiliation(s)
- Ruipeng Zhao
- Department of Orthopaedics, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, Shanxi, China
| | - Xiaochun Wei
- Department of Orthopaedics, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, Shanxi, China
| | - Shuai Hu
- Department of Orthopaedics, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, Shanxi, China
| | - Yixuan Zhang
- Department of Orthopaedics, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, Shanxi, China
| | - Hongru Wu
- Shanxi Institute of Sports Science, Taiyuan, 030001, Shanxi, China
| | - Pengcui Li
- Department of Orthopaedics, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, Shanxi, China
| | - Yu Zhao
- Department of Orthopaedics, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, The Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001, Shanxi, China.
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Wörner T, Thorborg K, Clarsen B, Eek F. Hip and groin function and strength in male ice hockey players with and without hip and groin problems in the previous season- a prospective cohort study. Phys Ther Sport 2021; 52:263-271. [PMID: 34678567 DOI: 10.1016/j.ptsp.2021.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/08/2021] [Accepted: 10/10/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To describe and compare hip and groin strength and function of male ice hockey players over one season in players with and without hip and groin problems in the previous season. DESIGN Prospective cohort study. SETTING Swedish male ice hockey. PARTICIPANTS We followed 193 players from 10 teams during the 2017/2018 season. MAIN OUTCOME MEASURES Hip adduction and abduction strength, 5 s squeeze test (5SST), and self-reported hip and groin function (Hip and Groin Outcome Score). Changes over the season and differences between players with and without problems in the previous season were analyzed by linear mixed models. RESULTS Adduction strength decreased slightly from pre-to mid-season and abduction strength increased slightly over the full season. However, self-reported function or pain did not change. Players with hip and groin problems in the previous season had significantly worse self-reported function, and more groin pain during the 5SST compared to players without. Strength measurments did not differ between groups. CONCLUSIONS Hip muscle strength, groin pain, and self-reported function appear to remain stable throughout the season in male ice hockey players. Remaining impairments in players with problems in the previous season suggest that function does not recover by ice hockey participation alone.
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Affiliation(s)
- Tobias Wörner
- Department of Health Sciences, Lund University, Lund, Sweden.
| | - Kristian Thorborg
- Sports Orthopedic Research Center-Copenhagen, Department of Orthopaedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Benjamin Clarsen
- Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway; Center for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Frida Eek
- Department of Health Sciences, Lund University, Lund, Sweden
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Beauchamp MK, Ward RE, Jette AM, Bean JF. Meaningful Change Estimates for the Late-Life Function and Disability Instrument in Older Adults. J Gerontol A Biol Sci Med Sci 2019; 74:556-559. [PMID: 30285090 PMCID: PMC6417450 DOI: 10.1093/gerona/gly230] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The Late-Life Function and Disability Instrument (LLFDI) is a well-validated and frequently used patient-reported outcome for older adults. The aim of this study was to estimate the minimal clinically important difference (MCID) of the LLFDI-Function Component (LLFDI-FC) and its subscales among community-dwelling older adults with mobility limitations. METHODS We performed a secondary analysis of the Boston Rehabilitative Impairment Study of the Elderly, a longitudinal cohort study of older adults with mobility limitations residing in the community. The MCID for each LLFDI-FC scale over 1 year of follow-up was estimated using both anchor- and distribution-based methods, including mean change scores on a patient-reported global rating of change in function scale, the standard error of measurement (SEM), and the minimal detectable change with 90% confidence (MDC90). RESULTS Data from 320 older adults were used in the analysis (mean age 76 years, 69% female, mean of four chronic conditions). Meaningful change estimates for "small change" based on the global rating of change and SEM were 2, 3, 4, and 4 points for the LLFDI-FC overall function scale and basic lower-extremity, advanced lower-extremity, and upper-extremity subscales, respectively. Estimates for "substantial change" based on the global rating of change and minimal detectable change with 90% confidence were 5, 6, 9, and 10 points for the overall function scale and basic lower-extremity, advanced lower-extremity, and upper-extremity subscales, respectively. CONCLUSION This study provides the first MCID estimates for the LLFDI-FC, a widely used patient-reported measure of function. These values can be used to interpret the outcomes of longitudinal investigations of functional status in similar populations of community-dwelling older adults.
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Affiliation(s)
- Marla K Beauchamp
- School of Rehabilitation Science, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Respiratory Research, West Park Healthcare Centre, Toronto, Ontario, Canada
| | - Rachel E Ward
- New England Geriatric Research Education and Clinical Center, Veterans Administration Boston Health System, Massachusetts
| | - Alan M Jette
- Health and Disability Research Institute, Boston University School of Health, Massachusetts
| | - Jonathan F Bean
- New England Geriatric Research Education and Clinical Center, Veterans Administration Boston Health System, Massachusetts
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
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Hoch JM, Baez SE, Hoch MC. Examination of ankle function in individuals with a history of ACL reconstruction. Phys Ther Sport 2019; 36:55-61. [PMID: 30660900 DOI: 10.1016/j.ptsp.2019.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/31/2018] [Accepted: 01/07/2019] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To determine the relationship between self-reported ankle and knee function, and to examine differences in ankle function between healthy and injured limbs in individuals with a history of ACL reconstruction (ACLR). DESIGN Cross-sectional. SETTING Laboratory. PARTICIPANTS A total of 18 adults with a history of ACLR. MAIN OUTCOME MEASURES Participants completed four patient-reported outcomes: the Knee Injury and Osteoarthritis Outcome (KOOS), the Fear-Avoidance Belief Questionnaire, the modified Disablement in the Physically Active Scale, and the Quick-Foot and Ankle Ability Measure (Quick-FAAM). Additional ankle function measures collected bilaterally included plantar cutaneous sensation, dorsiflexion range of motion and dorsiflexion and plantarflexion strength. RESULTS Three KOOS-subscales were significantly, moderately correlated to the Quick-FAAM for the injured limb. There were differences in the uninjured and injured Quick-FAAM scores. No other differences were observed in ankle function measures. CONCLUSIONS Self-reported ankle and knee function are correlated in participants with a history of ACLR. Clinicians should be made aware of the influence of this health condition on the distal joint, and treatment strategies to address these perceived impairments should be considered.
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Affiliation(s)
- Johanna M Hoch
- University of Kentucky, 206A Charles T Wethington Building, Lexington, KY, 40536, USA.
| | - Shelby E Baez
- University of Kentucky, 206 Charles T Wethington Building, Lexington, KY, 40536, USA
| | - Matthew C Hoch
- Sports Medicine Research Institute, University of Kentucky, 720 Sports Center Drive, Lexington, KY, 40536, USA
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Iversen MD, Price LL, von Heideken J, Harvey WF, Wang C. Physical examination findings and their relationship with performance-based function in adults with knee osteoarthritis. BMC Musculoskelet Disord 2016; 17:273. [PMID: 27405996 PMCID: PMC4941016 DOI: 10.1186/s12891-016-1151-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 07/02/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many physical examination (PE) maneuvers exist to assess knee function, none of which are specific to knee osteoarthritis (KOA). The Osteoarthritis Research Society International also recommends the use of six functional performance measures to assess function in adults with KOA. While earlier studies have examined the relationship between PE findings and self-reported function or PE findings and select performance tests in adults with knee pain and KOA, few have examined the all three types of measures. This cross-sectional study specifically examines the relationships between results of PE findings, functional performance tests and self-reported function in adults with symptomatic KOA. METHODS We used baseline PE data from a prospective randomized controlled trial in 87 participants aged ≥40 years with symptomatic and radiographic KOA. The PE performed by three experienced physical therapists included: muscle assessment, function and special tests. Participants also completed functional performance tests and the Western Ontario and McMaster Osteoarthritis Index (WOMAC). Multivariate linear regression identified contributions of PE findings towards functional performance and WOMAC scores, adjusting for age and gender. RESULTS Participants' mean age was 60.4 years (SD = 10.5), mean disease duration was 8.4 years (SD = 10.1) and 27 participants had varus knee alignment. Mean WOMAC pain and function scores were 211 (SD = 113) and 709 (SD = 394), respectively. Weakness was present in major hip and knee muscles. Seventy-nine participants had a positive Ely's, 65 a positive Waldron and 49 a positive Grind. Mean 6-min walk was 404 m (SD = 83) and mean Berg Balance was 53 (SD = 4). Regression analysis identified positive findings on 5 special tests (P < 0.05) as indicative of poorer 6 min walk. Positive Apley's was associated (P < 0.05) with slower 20 m walk and a positive Ober with poorer balance scores (P < 0.05). CONCLUSIONS Diminished hip muscle strength and flexibility, and patella dysfunction were prevalent in these adults with symptomatic KOA. Results of functional performance tests suggest balance and walking ability are impaired and are associated with PE findings of muscle length imbalance, hip muscle weakness and patella dysfunction. None of the PE measures were associated with self-reported function. Therefore, performance-based test results may be more useful in informing rehabilitation interventions.
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Affiliation(s)
- Maura D Iversen
- Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, 360 Huntington Avenue 301 C RB, Boston, MA, 02115, USA. .,Department of Medicine, Section of Clinical Sciences, Division of Rheumatology, Immunology & Allergy, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA. .,Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
| | - Lori Lyn Price
- Institute of Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.,Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA
| | - Johan von Heideken
- Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, 360 Huntington Avenue 301 C RB, Boston, MA, 02115, USA.,Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - William F Harvey
- Center for Integrative Medicine and Division of Rheumatology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Chenchen Wang
- Center for Integrative Medicine and Division of Rheumatology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
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Cosby NL, Koroch M, Grindstaff TL, Parente W, Hertel J. Immediate effects of anterior to posterior talocrural joint mobilizations following acute lateral ankle sprain. J Man Manip Ther 2012; 19:76-83. [PMID: 22547917 DOI: 10.1179/2042618610y.0000000005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Restrictions in ankle dorsiflexion range of motion (ROM) have been associated with decreased posterior talar glide in individuals with an acute lateral ankle sprain. Talocrural joint mobilizations may be used to restore joint arthrokinematics. Our purpose was to examine the effects of a single bout of anterior to posterior (AP) talocrural joint mobilization on self-reported function, dorsiflexion ROM, and posterior talar translation in individuals with an acute lateral ankle sprain. This single-blinded, randomized controlled trial utilized 17 volunteers (nine treatment and eight control) with an acute lateral ankle sprain (grade I/II) who were immobilized for a period of 1-7 days. The treatment group received a single 30-second bout of grade III AP talocrural joint mobilization the day their immobilization device was removed, while the control group did not receive any intervention. Active dorsiflexion ROM and posterior talar translation were assessed before, immediately after, and 24 hours after receipt of the treatment or control interventions. Self-reported function and pain were assessed before and 24 hours after the receipt of the treatment or control interventions using the foot and ankle disability index. Collectively all groups demonstrated improved dorsiflexion ROM and self-reported function. There was a significant decrease in pain perception at 24-hour follow-up for the treatment group. A single bout of AP talocrural joint mobilizations may not have an immediate effect on ankle dorsiflexion ROM, posterior talar translation, or self-reported function; however, they may have an immediate effect on pain perception in individuals with an acute lateral ankle sprain.
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