چکیده:
Objective:The aim of this study was to extract suitable spatiotemporal and kinematic parameters to determine how Total Knee Replacement (TKR) alters patients’ knee kinematics during gait, using a rapid and simplified quantitative two-dimensional gait analysis procedure. Methods:Two-dimensional kinematic gait pattern of 10 participants were collected before and after the TKR surgery, using a 60 Hz camcorder in sagittal plane. Then, the kinematic parameters were extracted using the gait data. A student t-test was used to compare the group-average of spatiotemporal and peak kinematic characteristics in the sagittal plane. The knee condition was also evaluated using the Oxford Knee Score (OKS) Questionnaire to ensure thateach subject was placed in the right group. Results:The results showed a significant improvement in knee flexion during stance and swing phases after TKR surgery. The walking speed was increased as a result of stride length and cadence improvement, but this increment was not statistically significant. Both post-TKR and control groups showed an increment in spatiotemporal and peak kinematic characteristics between comfortable and fast walking speeds. Conclusion:The objective kinematic parameters extracted from 2D gait data were able to show significant improvements of the knee joint after TKR surgery. The patients with TKR surgery were also able to improve their knee kinematics during fast walking speed equal to the control group. These results provide a good insight into the capabilities of the presented method to evaluate knee functionality before and after TKR surgery and to define a more effective rehabilitation program.
خلاصه ماشینی:
Both post-TKR and control groups showed an increment in spatiotemporal and peak kinematic characteristics between comfortable and fast walking speeds.
The patients with TKR surgery were also able to improve their knee kinematics during fast walking speed equal to the control group.
In a more recent study, three-dimensional motion analysis was used to compare spatiotemporal and peak kinematic characteristics between post-TKR and control groups at comfortable and fast walking speeds (14).
Their results showed that the post-TKR patients were able to increase their velocity, cadence and stride length by a similar proportion equal to the control ones during the fast walking speed condition.
It also showed that at a faster walking speed the kinematic parameters such as maximum knee flexion during stance and swing were altered in a similar manner for both post-TKR and control groups.
Therefore, the aim of this study was to investigate the possibility of extracting reliable objective parameters by using a simplified and rapid two-dimensional gait analysis method for patients following TKR surgery, which only needs preliminary equipment, namely a 60Hz camcorder, three reflective markers and an open source image processing software (16).
Walking velocity, stride length and cadence were extracted directly from the trimmed and calibrated videos using Kinovea software and the peak kinematic parameters were extracted from the knee flexion diagram over a full gait cycle.
In post-TKR patients at comfortable walking speed cadence, maximum knee flexion and extension during stance have a moderate correlation with the subjective OKS; but at fast walking speeds, there is moderate and high (0.