東華大學圖書館 |

語系: 繁體中文

說明(常見問題)

回圖書館首頁

手機版館藏查詢

登入

回首頁

切換: 標籤 | MARC模式 | ISBD

Gait performance for individuals aft...

University of Delaware., Department of Health, Nutrition and Exercise Sciences.

FindBook

Google Book

Amazon

博客來

Gait performance for individuals after total knee arthroplasty: A longitudinal analysis.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Gait performance for individuals after total knee arthroplasty: A longitudinal analysis./
作者:	Yoshida, Yuri.
面頁冊數:	209 p.
附註:	Adviser: Lynn Snyder-Mackler.
Contained By:	Dissertation Abstracts International70-09B.
標題:	Biophysics, Biomechanics. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3373319
ISBN:	9781109393873

Gait performance for individuals after total knee arthroplasty: A longitudinal analysis.
Yoshida, Yuri.

Gait performance for individuals after total knee arthroplasty: A longitudinal analysis. - 209 p.

Adviser: Lynn Snyder-Mackler.

Thesis (Ph.D.)--University of Delaware, 2009.

Total knee arthroplasty (TKA) is one of the most common knee surgeries performed on individuals with knee osteoarthritis (OA). Although TKA successfully reduces arthritic pain, realigns the deformed lower extremity, increases range of motion of the knee and improves patients' functional performance, the patients do not obtain favorable functional outcomes compared to the age-matched healthy individuals. "When will I walk normally?" is one of the most important questions by patients who have a plan to undergo TKA. Despite many reports about gait analysis for patients after TKA, the conclusive answer has been controversial because many factors may contribute to their gait.

ISBN: 9781109393873Subjects--Topical Terms:

1035342
Biophysics, Biomechanics.

Gait performance for individuals after total knee arthroplasty: A longitudinal analysis.
LDR:06262nmm 2200373 a 45 001 866687
005 20100802
008 100802s2009 ||||||||||||||||| ||eng d
020 $a 9781109393873
035 $a (UMI)AAI3373319
035 $a AAI3373319
040 $a UMI $c UMI
100 1 $a Yoshida, Yuri. $3 1035343
245 1 0 $a Gait performance for individuals after total knee arthroplasty: A longitudinal analysis.
300 $a 209 p.
500 $a Adviser: Lynn Snyder-Mackler.
500 $a Source: Dissertation Abstracts International, Volume: 70-09, Section: B, page: .
502 $a Thesis (Ph.D.)--University of Delaware, 2009.
520 $a Total knee arthroplasty (TKA) is one of the most common knee surgeries performed on individuals with knee osteoarthritis (OA). Although TKA successfully reduces arthritic pain, realigns the deformed lower extremity, increases range of motion of the knee and improves patients' functional performance, the patients do not obtain favorable functional outcomes compared to the age-matched healthy individuals. "When will I walk normally?" is one of the most important questions by patients who have a plan to undergo TKA. Despite many reports about gait analysis for patients after TKA, the conclusive answer has been controversial because many factors may contribute to their gait.
520 $a Quadriceps weakness of the operated limb is the primary post-operative impairment after TKA. Patients after TKA have drastically increased quadriceps weakness of the operated limb immediately after TKA, and it gradually increases to match to the nonoperated limb. They cannot achieve the level of age-matched healthy comparisons although strengthening protocols are effective to increase the strength. Moreover, quadriceps weakness of the operated limb is related to the patients' functional outcomes, and also resulted in asymmetrical functional performance such as rising from a chair and walking. Patients demonstrated asymmetrical gait patterns depending on the quadriceps strength of the nonoperated limb in acute post-TKA. Then, they altered joint strategies, using greater hip extensor moments during loading response instead of lower knee extensor moment, in order to obtain symmetrical gait patterns at 1 year after TKA. Most patients can achieve symmetrical quadriceps strength between limbs 3 years after TKA; however, there was no explanation of how enhanced quadriceps strength would affect gait patterns 3 years after TKA.
520 $a The first goal of this project was to investigate changes in gait patterns in 3 months, 1 year and 3 years after TKA in order to determine whether patients after TKA can take advantage of increased quadriceps strength of the operated limb which results in more symmetrical strength between limbs. Patients after TKA (n=13) can improve their gait patterns at some level. Their quadriceps strength of the nonoperated limb decreased from 1 year to 3 years after TKA. Patients after TKA can achieve symmetrical gait patterns such as improved knee flexion and extension excursion in 3 years after TKA. Patients after TKA still demonstrated lower peak knee extension and lower ankle plantarflexor moment during midstance with lower gastrocnemius activity of the operated limb compared to the nonoperated limb. Overall gait asymmetrical patterns, representing by ground reaction forces, were predicted by many factors. Peak ground reaction forces of the operated limb 3 months after TKA was predicted by only knee extensor moment during loading response while peak ground reaction forces of the operated limb 1 year after TKA was predicted by speed and other factors. The causes of gait asymmetry of patients after TKA changed over time.
520 $a Quadriceps of the nonoperated limb cannot be called healthy as a reference. Quadriceps of the nonoperated limb started to weaken 1 year after TKA which may contribute to secondary knee OA. Therefore, the true prognosis of gait patterns after TKA cannot be concluded without comparing to the age-matched healthy individuals. The second goal of this project was to determine how gait patterns changed in patients after TKA (n=14) compared to the age-, weight- and gender- matched healthy individuals (n=14). There were no significant improvements in TKA group compared to the healthy comparisons in joint kinematics and kinetics; however, patients after TKA persistently walked differently from the age-matched healthy individuals. Additionally, the nonoperated limb in TKA group demonstrated less knee motion during stance with lower quadriceps activity over time compared to the healthy comparisons. Our finding confirmed that quadriceps strength is not the only impairment to alter gait patterns for individuals after TKA.
520 $a The patients who have a plan to undergo TKA were concerned whether they can walk normally. Therefore, the third goal of this project was to investigate whether patients after TKA (N=13) could walk similarly to the age-matched healthy controls (N=13). This patients could walk similar gait speed and had adequate quadriceps strength compared to the age-matched healthy controls. Correspondingly, their gait patterns became similar to the age-matched healthy controls. Strong quadriceps strength and faster gait speed played an important role to improve gait patterns for patients 3 years after TKA.
520 $a The last aim is to understand whether the altered gait patterns were disadvantageous for individuals after TKA (n=21). Altered muscle activity of quadriceps, greater co-contraction, was not related to the quadriceps strength at the same testing time, but it was related to the prognosis of quadriceps strength. If individuals demonstrated altered muscle activity during gait, it may interfere with quadriceps strengthening. (Abstract shortened by UMI.)
590 $a School code: 0060.
650 4 $a Biophysics, Biomechanics. $3 1035342
650 4 $a Health Sciences, Rehabilitation and Therapy. $3 1017926
690 $a 0382
690 $a 0648
710 2 $a University of Delaware. $b Department of Health, Nutrition and Exercise Sciences. $3 1019260
773 0 $t Dissertation Abstracts International $g 70-09B.
790 $a 0060
790 1 0 $a Knight, Christopher A. $e committee member
790 1 0 $a Petterson, Stephanie C. $e committee member
790 1 0 $a Royer, Todd D. $e committee member
790 1 0 $a Snyder-Mackler, Lynn, $e advisor
791 $a Ph.D.
792 $a 2009
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3373319