title: The effect of walking speed on gait kinematics and kinetics after endoprosthetic knee replacement following bone tumor resection.
abstract: Gait function is one of the most important components of functional outcome evaluation in patients with a tumor around the knee. In addition to walking at a preferred speed, the patients might be sometimes required to walk fast in daily life (e.g., schooling and working) because the major types of bone tumors often occur in adolescence and young adults. Therefore, recovering the ability to walk fast would increase the quality of life of these patients. To clarify which parts of the lower limb are exerted while walking fast, we investigated the kinematic and kinetic changes during fast walking in patients who underwent endoprosthetic knee replacement after bone tumor resection. Laboratory-based gait analysis was performed on eight patients who had undergone endoprosthetic knee replacement following resection of a tumor around the knee. Patients walked at a preferred and faster speed, and the gait parameters were compared between the two walking speeds for each leg. To increase walking speed, patients tended to rely on the bilateral hip, ankle, and contralateral knee to generate additional power. Kinetic analysis showed that involved-side vertical body support was not significantly increased during late stance to increase walking speed, which was associated with a small increase in ankle plantarflexion moment and concentric power. These results suggest to patients after knee reconstruction how to effectively increase their walking speed or redistribute the mechanical load on the muscles and joints to prevent excessive stress on the lower limbs.
authors.affiliation: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Electronic address: okita.yusuke@gmail.com.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Okita
authors.affiliation: Department of Rehabilitation, Kobe Minimally Invasive Cancer Center, Kobe, Japan.
authors.forename: Noriatsu
authors.initials: N
authors.lastname: Tatematsu
authors.affiliation: Department of Physical Therapy, Hyogo University of Health Sciences, Kobe, Japan.
authors.forename: Koutatsu
authors.initials: K
authors.lastname: Nagai
authors.affiliation: Department of Orthopaedic Surgery, Toyooka Hospital, Toyooka, Hyogo, Japan.
authors.forename: Tomitaka
authors.initials: T
authors.lastname: Nakayama
authors.affiliation: Department of Orthopaedic Surgery, Rakuwakai Otowa Hospital, Kyoto, Japan.
authors.forename: Takeharu
authors.initials: T
authors.lastname: Nakamata
authors.affiliation: Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okamoto
authors.affiliation: Department of Tissue Regeneration, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Toguchida
authors.affiliation: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Ichihashi
authors.affiliation: Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Matsuda
authors.affiliation: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Tadao
authors.initials: T
authors.lastname: Tsuboyama
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology; D019645:Arthroplasty, Replacement, Knee; D001696:Biomechanical Phenomena; D001859:Bone Neoplasms / Q000503:physiopathology / Q000601:surgery*; D003430:Cross-Sectional Studies; D051341:Dependent Ambulation / Q000502:physiology*; D005260:Female; D005266:Femoral Neoplasms / Q000503:physiopathology / Q000601:surgery*; D005684:Gait / Q000502:physiology*; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013977:Tibia / Q000601:surgery*; D016138:Walking / Q000502:physiology
keywords: Bone tumor; Gait asymmetry; Knee endoprosthesis; Walking speed