Total knee arthroplasty improves gait adaptability in osteoarthritis patients; a pilot study

Total knee arthroplasty improves gait adaptability in osteoarthritis patients; a pilot study

Booij, M.J. (Vrije Universiteit Amsterdam)
van Royen, B. J. (Universiteit van Amsterdam; Vrije Universiteit Amsterdam)
Nolte, P. A. (Spaarne Gasthuis)
Twisk, J. W.R. (VU University Medical Centre)
Harlaar, J. (TU Delft Biomechatronics & Human-Machine Control; Erasmus MC)
van den Noort, J. C. (Universiteit van Amsterdam)

2022

Background: Gait adaptability is of utmost importance for keeping balance during gait in patients with knee osteoarthritis, also after total knee arthroplasty (TKA). The aims of this explorative study are: (1) assess the effect of age, knee osteoarthritis and TKA on gait adaptability; (2) assess changes in gait adaptability pre-to post-TKA and (3) their relation to functional outcomes. Methods: Gait adaptability was measured using a Target Stepping Test (TST) in knee osteoarthritis patients before (preTKA) and 12 months after TKA (postTKA) and compared to asymptomatic old (AsOld) and young adults (AsYng). TST imposed an asymmetrical gait pattern with projected stepping targets at high walking speed. Gait adaptability was determined through stepping accuracy on the targets. The Oxford Knee Score (OKS) and Timed-Up-and-Go test (TUG) measured patients’ physical function. Results: 12 preTKA, 8 postTKA, 18 AsYng, 21 AsOld were tested. Age showed no effect on TST-stepping accuracy. PreTKA showed worse TST-stepping accuracy compared to AsYng and AsOld (7.7; 6.2 cm difference). PostTKA showed an improvement of 52% in TST-stepping accuracy compared to preTKA (3.2 cm). Higher stepping accuracy preTKA predicted higher stepping accuracy post-TKA. In addition, low preTKA stepping accuracy predicted more improvement postTKA. Pre-to post-TKA improvement of stepping accuracy was related to improvement on the TUG (Beta = 0.17, p = 0.024), but not to OKS. Conclusions: Gait adaptability is improved following TKA in knee osteoarthritis patients and no longer significantly worse than asymptomatic adults. The relation of gait adaptability to function is shown by its relation to the TUG and shows to have predictive value pre-to post-TKA.

Aging
Motor control
Stepping stones
Total knee replacement
Walking adaptability

http://resolver.tudelft.nl/uuid:5d94972e-48f4-4728-81c6-1a4257788790

https://doi.org/10.1016/j.jor.2022.08.003

Journal of Orthopaedics, 34, 304-309

Institutional Repository

journal article

© 2022 M.J. Booij, B. J. van Royen, P. A. Nolte, J. W.R. Twisk, J. Harlaar, J. C. van den Noort