Post-operative Physical Performance Factors Associated With Gait Speed in Patients Surgically Treated for Hip Fracture: A Cross-Sectional Study
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective To determine post-operative physical performance factors associated with gait speed in patients surgically treated for hip fracture. Methods Cross-sectional data from 59 patients (16 males and 43 females; mean age, 79.2±9.1 years) who underwent hip fracture surgery were enrolled. Patients completed a 10-meter walk test (10MWT) to assess gait speed. Additional physical performance tests included the Timed Up and Go test (TUG), the Berg Balance Scale (BBS), maximum voluntary isometric contraction (MVIC) of the knee extensors and flexors on the operated and non-operated sides as well as of the hip abductors (all tested using air-resistance weight machines), and analysis of spatio-temporal gait parameters at about 6 weeks after hip surgery. Results Bivariate analyses revealed a significant positive correlation between the post-operative 10MWT and the post-operative TUG, age, swing phase duration, and gait cycle duration along with a significant negative correlation between post-operative BBS score, MVIC of the knee extensors and flexors on the operated and non-operated sides, MVIC of the hip abductors, and cadence and stance phase duration. Linear regression analyses revealed that the post-operative TUG (β=0.85, p<0.01), gait cycle duration (β=0.17, p=0.02), and osteoporosis (β=-0.18, p=0.02) were associated with the post-operative 10MWT. Conclusion The presence of osteoporosis, post-operative balance, and isometric muscle strength in the operated and non-operated legs were statistically associated with post-operative gait speed early after hip fracture surgery.
Abstract
Objective To determine post-operative physical performance factors associated with gait speed in patients surgically treated for hip fracture. Methods Cross-sectional data from 59 patients (16 males and 43 females; mean age, 79.2±9.1 years) who underwent hip fracture surgery were enrolled. Patients completed a 10-meter walk test (10MWT) to assess gait speed. Additional physical performance tests included the Timed Up and Go test (TUG), the Berg Balance Scale (BBS), maximum voluntary isometric contraction (MVIC) of the knee extensors and flexors on the operated and non-operated sides as well as of the hip abductors (all tested using air-resistance weight machines), and analysis of spatio-temporal gait parameters at about 6 weeks after hip surgery. Results Bivariate analyses revealed a significant positive correlation between the post-operative 10MWT and the post-operative TUG, age, swing phase duration, and gait cycle duration along with a significant negative correlation between post-operative BBS score, MVIC of the knee extensors and flexors on the operated and non-operated sides, MVIC of the hip abductors, and cadence and stance phase duration. Linear regression analyses revealed that the post-operative TUG (β=0.85, p<0.01), gait cycle duration (β=0.17, p=0.02), and osteoporosis (β=-0.18, p=0.02) were associated with the post-operative 10MWT. Conclusion The presence of osteoporosis, post-operative balance, and isometric muscle strength in the operated and non-operated legs were statistically associated with post-operative gait speed early after hip fracture surgery.
참고문헌 (38)
- World Health Organization, "Osteoporosis: both health organizations and individuals must act now to avoid an impending epidemic", World Health Organization, ~ (1999)
- 최의성, "한국에서의 고관절 골절 빈도는 여전히 증가 추세인가?: 건강보험 데이터베이스를 이용한 역학연구", 대한정형외과학회지, 51(6), pp.447~454 (2016), 대한정형외과학회
- Gialanella B, "Determinants of functional outcome in hip fracture patients : the role of specific neuropsychiatric symptoms", Disabil Rehabil, 37, pp.517~522 (2015)
- Jette AM, "Functional recovery after hip fracture", Arch Phys Med Rehabil, 68, pp.735~740 (1987)
- Mossey JM, "Determinants of recovery 12 months after hip fracture : the importance of psychosocial factors", Am J Public Health, 79, pp.279~286 (1989)
- Young Y, "A longitudinal examination of functional recovery among older people with subcapital hip fractures", J Am Geriatr Soc, 45, pp.288~294 (1997)
- Ingemarsson AH, "Walking ability and activity level after hip fracture in the elderly : a follow-up", J Rehabil Med, 35, pp.76~83 (2003)
- Whitehead C, "Falls in communitydwelling older persons followinig hip fracture : impact on self-efficacy, balance and handicap", Clin Rehabil, 17, pp.899~906 (2003)
- van den Akker-Scheek I, "Recovery of gait after short-stay total hip arthroplasty", Arch Phys Med Rehabil, 88, pp.361~367 (2007)
- Hodt-Billington C, "Changes in gait symmetry, gait velocity and self-reported function following total hip replacement", J Rehabil Med, 43, pp.787~793 (2011)
- Coulter CL, "Physiotherapist-directed rehabilitation exercises in the outpatient or home setting improve strength, gait speed and cadence after elective total hip replacement : a systematic review", J Physiother, 59, pp.219~226 (2013)
- Kolk S, "Gait and gait-related activities of daily living after total hip arthroplasty: a systematic review", Clin Biomech (Bristol, Avon), 29, pp.705~718 (2014)
- Lamoureux EL, "The relationship between lower body strength and obstructed gait in community-dwelling older adults", J Am Geriatr Soc, 50, pp.468~473 (2002)
- Roy MA, "Reliability of hand-held dynamometry in assessment of knee extensor strength after hip fracture", Am J Phys Med Rehabil, 83, pp.813~818 (2004)
- Lamb SE, "Mobility after proximal femoral fracture : the relevance of leg extensor power, postural sway and other factors", Age Ageing, 24, pp.308~314 (1995)
- Madsen OR, "Quadriceps strength in women with a previous hip fracture : relationships to physical ability and bone mass", Scand J Rehabil Med, 32, pp.37~40 (2000)
- Ji-Ho Kang, "Determinants of Functional Outcomes Using Clinical Pathways for Rehabilitation After Hip Fracture Surgery", Annals of geriatric medicine and research, 22(1), pp.26~32 (2018), 대한노인병학회[DOI]
- Freter SH, "Relationship between timed ‘up and go’ and gait time in an elderly orthopaedic rehabilitation population", Clin Rehabil, 14, pp.96~101 (2000)
- 정한영, "한글화된 Berg 균형검사법의 신뢰도 분석", Annals of Rehabilitation Medicine, 30(6), pp.611~618 (2006), 대한재활의학회
- Bugane F, "Estimation of spatial-temporal gait parameters in level walking based on a single accelerometer : validation on normal subjects by standard gait analysis", Comput Methods Programs Biomed, 108, pp.129~137 (2012)
- Thingstad P, "Identification of gait domains and key gait variables following hip fracture", BMC Geriatr, 15, pp.150~ (2015)
- Morri M, "At discharge gait speed and independence of patients provides a challenges for rehabilitation after total joint arthroplasty : an observational study", Arch Physiother, 6, pp.6~ (2016)
- Lord S, "Moving forward on gait measurement : toward a more refined approach", Mov Disord, 28, pp.1534~1543 (2013)
- Kline Mangione K, "Predictors of gait speed in patients after hip fracture", Physiother Can, 60, pp.10~18 (2008)
- Gausden EB, "Gait analysis after intertrochanteric hip fracture : does shortening result in gait impairment", J Orthop Trauma, 32, pp.554~558 (2018)
- Tinetti ME, "Home-based multicomponent rehabilitation program for older persons after hip fracture : a randomized trial", Arch Phys Med Rehabil, 80, pp.916~922 (1999)
- Leiper CI, "Relationships between physical activity and temporal-distance characteristics of walking in elderly women", Phys Ther, 71, pp.791~803 (1991)
- Blanke DJ, "Comparison of gait of young men and elderly men", Phys Ther, 69, pp.144~148 (1989)
- Brach JS, "Physical impairment and disability : relationship to performance of activitiesof daily living in community-dwelling older men", Phys Ther, 82, pp.752~761 (2002)
- Bohannon RW, "Reference values for extremity muscle strength obtained by hand-held dynamometry from adults aged 20 to 79 years", Arch Phys Med Rehabil, 78, pp.26~32 (1997)
- Woodward LM, "Most functional outcomes are similar for men and women after hip fracture : a secondary analysis of the enhancing mobility after hip fracture trial", BMC Geriatr, 14, pp.140~ (2014)
- Nankaku M, "Prediction of ambulation ability following total hip arthroplasty", J Orthop Sci, 16, pp.359~363 (2011)
- Radosavljevic N, "Estimation of functional recovery in patients after hip fracture by Berg Balance Scale regarding the sex, age and comorbidity of participants", Geriatr Gerontol Int, 13, pp.365~371 (2013)
- Leijendekkers RA, "Gait symmetry and hip strength in women with developmental dysplasia following hip arthroplasty compared to healthy subjects : a cross-sectional study", PLoS One, 13, pp.e0193487~ (2018)
- Kubota M, "Changes in gait pattern and hip muscle strength after open reduction and internal fixation of acetabular fracture", Arch Phys Med Rehabil, 93, pp.2015~2021 (2012)
- Portegijs E, "Leg extension power deficit and mobility limitation in women recovering from hip fracture", Am J Phys Med Rehabil, 87, pp.363~370 (2008)
- Lindsey C, "Association of physical performance measures with bone mineral density in postmenopausal women", Arch Phys Med Rehabil, 86, pp.1102~1107 (2005)
- Dostanpor A, "Relationships between walking speed, T-score and age with gait parameters in older post-menopausal women with low bone mineral density", Gait Posture, 64, pp.230~237 (2018)
