Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Wretschitsch, P.
Continuous Measurement and Monitoring of the Postoperative Remobilization after Primary TKA
[ Diplomarbeit ] Medical University of Graz; 2012. pp. 55
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Clar Heimo
- Leithner Andreas
- Sadoghi Patrick
- Altmetrics:
- Abstract:
- Introduction: Partial weight bearing, as therapeutical prescription, can be used in the non operative rehabilitation following trauma or after surgical interventions at the lower extremity. Regarding the lower extremities, forearm crutches are the kind of assistive devices, which allow a necessary load-removal. In daily practice the patients learn to appraise their allowed load force of the lower extremity by using a common bathroom scale. As described in previous studies, this static training does not fulfill the requirements, which occur during a gait cycle under dynamic loads. According to literature, it is impossible for the physical therapist and medical doctor to determine whether the partial weight bearing is performed in a correct way. This inaccurate method holds insecurities for the rehabilitative therapy and can lead to a worse healing process or even an operation or reoperation. Material and Methods: With the aid of sensor-supported forearm crutches it is possible to inspect the ¿bathroom scale training¿ accurately and assess if patients keep the designated weight bearing. Thirty-one patients, who had undergone cemented primary total knee arthroplasty, were investigated. The postoperative rehabilitation was performed under standardized physico-therapeutical schemes for partial weight bearing using forearm crutches. The optional biofeedback mode was not activated in this study. The loads on the affected extremity were logged and evaluated by the sensor-crutches. Within this constant monitoring, it is possible to examine patients, according to their performance in weight-bearing. Results: 31 patients (14 men and 17 women) were examined in total. The mean age was 66 years (48-84). The mean total body weight was 83 kg (51¿125). Overall 34.652 gait cycles were analyzed, 1 117 steps per person on average. Thereof 269 steps (24%) per person were in the prescribed range (½ total bodyweight ±. 5kg). With a statistical spread of 35- 6251, the missteps (76%) were 848 on average. At the overload- steps (56%), 66% were between 5 kg and 15 kg over the area of tolerance. Thirteen percent were over 20 kg and 20% over 25 kg. Conclusion: On the basis of the evaluated data, we conclude that TKA-patients are not able to perform the prescribed partial weight bearing during their remobilization as prescribed. Although it has to be considered that the patients we included tended to reduce weight-bearing due to postoperative pain. Within this constant monitoring of a prescribed partial weight-bearing, rehabilitation schemes and their indication could become better reproducible and researchable. Further research including the sensor crutches with constant feedback is in progress.