Changes in gait parameters during rehabilitation after total knee arthroplasty

Knee arthroplasty (KAP) is a cost-effective and reliable treatment for knee osteoarthritis with the predicted increase in demand. Clinical assessment systems for the effectiveness of rehabilitation do not fully reflect the recovery process, but the evaluation of biomechanical gait parameters is most objective.

Objective: to study of the changes in the biomechanical gait parameters after KAP for osteoarthritis.

Subjects and methods. A total of 54 patients (31 women and 23 men; mean age, 63.86+1.69 years) were examined an average of 3.94+1.40 months after KAP at the Ivanovo Regional Hospital for War Veterans. A control group consisted of 49 people (28 women and 21 men; mean age, 34.6+8.8 years). Walking performance was studied three times: at admission, one and two weeks after the end of a cycle. Gait parameters were recorded using a Stedis feedback walking simulator (OOO “Neurosoft”, Ivanovo, Russia) in the Assessment package (Registration certificate No. РЗН 2018/7458 dated 08.07.2018). The results were processed using the standard biomedical statistical methods at a significance level of 5%.

Results and discussion. In the early recovery period, the patients’ walking after KAP was characterized by decreased speed, by the symptoms of unloading, and by a slight lower extremity functional asymmetry. The revealed phenomena were suggestive of both positive changes in the recovery process as a whole and the normalization of the temporal pattern of a step cycle. It was established that walking speed and the double support period of gait were not restored 3 months after KAP. The main biomechanical changes were non-specific and were associated with reduced walking speed. It was suggested that physical therapy should be aimed mainly at increasing the stride length when controlling dynamic loads. The criterion for the effectiveness of rehabilitation was to reduce asymmetry when walking.

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