Article

OBJECTIVE: To evaluate the effects of surgery and a postoperative progressive
home exercise program on gait parameters among individuals operated with total
knee arthroplasty. DESIGN: Single blinded randomized controlled trial. SUBJECTS:
108 patients (84 females, 24 males, mean age 69 years). INTERVENTIONS: Patients
were equally randomized into an exercise group (EG) and control group (CG). The 12-months progressive home exercise program starting two months postoperatively
was compared to usual care. METHODS: Gait analysis was performed using the
Gaitrite electronic walkway system. In addition, knee extension and flexion
strength were measured by a dynamometer preoperatively, and pain on visual analog
scale (VAS) at two months and 14 months postoperatively. RESULTS: At the 12-month
follow-up, maximal gait velocity (p=0.006), cadence (p=0.003) and stance time
(p=0.039) showed a greater increase among EG than CG.
All the other gait
parameters improved among both groups, but with not statistically discernible
difference between groups. Weak correlations were found between changes in
maximal gait velocity and the knee extension (r=-0.31, p=0.002), flexion strength
(r=0.28, p=0.004) and pain during loading (r=-0.27, p=0.005) values. CONCLUSION:
The intervention produced statistically significant changes in maximal gait
velocity, cadence and stance times in the exercise group compared to controls.
Although the average change was small it is of importance that biggest changes
occurred in those with low performance.
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Langue : ANGLAIS