Clinical interpretability of quadriceps strength and gait speed performance in total knee arthroplasty: A longitudinal study

Yong-Hao Pua; Cheryl Lian-Li Poon; Felicia Jie-Ting Seah; John Wei-Ming Tan; Ee-Lin Woon; Hwei-Chi Chong; Julian Thumboo; Ross Allan Clark; Seng-Jin Yeo

doi:10.1097/PHM.0000000000002176

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Clinical interpretability of quadriceps strength and gait speed performance in total knee arthroplasty: A longitudinal study

Journal article

Peer reviewed

Clinical interpretability of quadriceps strength and gait speed performance in total knee arthroplasty: A longitudinal study

Yong-Hao Pua, Cheryl Lian-Li Poon, Felicia Jie-Ting Seah, John Wei-Ming Tan, Ee-Lin Woon, Hwei-Chi Chong, Julian Thumboo, Ross Allan Clark and Seng-Jin Yeo

American Journal of Physical Medicine & Rehabilitation, Vol.102(5), pp.389-395

2023

DOI: https://doi.org/10.1097/PHM.0000000000002176

PMID: 36728706

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Abstract

knee

replacement

patient reported outcome measures

interpretability

Following a total knee arthroplasty (TKA), physical assessments of quadriceps strength and gait speed performance are often undertaken during rehabilitation. Our study aimed to improve their clinical interpretability by examining trajectory curves across levels of self-reported walking and stair climbing function. A sample of 2,624 patients with primary TKA participated in this retrospective longitudinal study. Monthly, for 4 months post-surgery, quadriceps strength and gait speed were quantified. At the Month-6 timepoint, self-reported walking and stair climbing function was measured. All physical measures improved nonlinearly over time. In mixed-effects models, greater quadriceps strength and gait speed over time were associated with higher Month-6 self-reported walking and stair climbing function (P-values<0.001). Steeper gains in quadriceps strength and gait speed were associated with higher levels of walking and stair-climbing function (interaction P-values<0.001). Amongst female patients who had great difficulty with stair ascent and ambulation, quadriceps strength trajectory curves plateaued after 8 weeks post TKA. By stratifying trajectory curves across clinically interpretable functional levels, our findings potentially provide patients and clinicians a means to better interpret the continuous-scaled quadriceps strength and gait speed values. This information may be valuable when engaging patients in shared decision making and expectation setting.

Details

Title: Clinical interpretability of quadriceps strength and gait speed performance in total knee arthroplasty: A longitudinal study
Authors: Yong-Hao Pua (Corresponding Author) - Singapore General Hospital
Cheryl Lian-Li Poon (Author) - Singapore General Hospital
Felicia Jie-Ting Seah (Author) - Sengkang General Hospital
John Wei-Ming Tan (Author) - Singapore General Hospital
Ee-Lin Woon (Author) - Singapore General Hospital
Hwei-Chi Chong (Author) - Changi General Hospital
Julian Thumboo (Author) - Singapore General Hospital
Ross Allan Clark (Author) - University of the Sunshine Coast, Queensland, School of Health - Public Health
Seng-Jin Yeo (Author) - Singapore General Hospital
Publication details: American Journal of Physical Medicine & Rehabilitation, Vol.102(5), pp.389-395
Publisher: Lippincott Williams & Wilkins
DOI: 10.1097/PHM.0000000000002176
ISSN: 1537-7385
PMID: 36728706
Organisation Unit: School of Health - Public Health
Language: English
Record Identifier: 99705196202621
Output Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Web Of Science research areas: Rehabilitation; Sport Sciences

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