Gait during hydrokinesitherapy following total knee arthroplasty.
OBJECTIVE
To obtain gait parameters during hydrotherapy (HT) in patients who were referred for rehabilitation after primary total knee arthroplasty (TKA).


METHODS
The study had a cohort prospective design. Patients who had undergone TKA followed a HT rehabilitation programme. Twenty-two consecutive patients were enrolled. Four of them dropped out for various reasons, independently of HT. Therefore 18 patients could be evaluated (5 men and 13 women). Eighteen age-matched healthy volunteers were the control subjects. Nine patients had a right TKA and nine a left TKA. On the average HT duration was 18.4 days (SD 1.4).


RESULTS
The patients presented with a mean speed of 912 (SD 275) meters per hour (m/h) at the baseline. At the last session the mean speed was 1330 (SD 416) m/h. The mean stance duration was 1.75 s (SD 0.34) on the operated side and 1.83 s (SD 0.41) on the non-operated side. By contrast, the mean swing duration was 1.10 s (SD 0.25) on the operated side and 1.13 s (SD 0.34) on the non-operated side. The step duration was the same on both sides. At the beginning of HT the mean stance/swing ratio was 1.94 on the operated side, whereas it was 1.77 on the non-operated side. In the controls the ratio was 1.46. At the beginning the mean stride length was 0.526 m (SD 0.147) and the value became 0.556 (SD 0.138) after 18 training sessions. At the individual level, recovery occurred in a non-linear fashion (Best Fitting, 7th-grade Fourier finite series).


CONCLUSIONS
The study design permits accurate definition of stride parameters during rehabilitation which allows optimization of the programme. Increase in speed and regain of balance are the main targets of a HT programme and are monitored on a daily basis.
Giaquinto
Salvatore
S
IRCCS San Raffaele Pisana, via della Pisana235, IT-00163, Rome, Italy. salvatore.giaquinto@sanraffaele.it
Ciotola
Elena
E
Margutti
Ferdinando
F
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D016022:Case-Control Studies; D005260:Female; D005583:Fourier Analysis; D005684:Gait / Q000502:physiology*; D006801:Humans; D006875:Hydrotherapy; D008297:Male; D004856:Postural Balance / Q000502:physiology; D011446:Prospective Studies; D014741:Video Recording