Does backward gait require more proprioception and balance in older adults after total knee arthroplasty?

Author: Fatih Özden1, İsmail Uysal2, İsmet Tümtürk3, Mehmet Özkeskin4, Fatih Özyer5
Affiliation:
1 Muğla Sıtkı Koçman University, Köyceğiz Vocational School of Health Services, Department of Health Care Services, Muğla, Turkey.
2 Muğla Sıtkı Koçman University, Fethiye Vocational School of Health Services, Department of Health Care Services, Muğla, Turkey.
3 Süleyman Demirel University, Institute of Health Sciences, Department of Physiotherapy and Rehabilitation, Isparta, Turkey.
4 Ege University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, İzmir, Turkey.
5 Fethiye State Hospital, Department of Orthopaedics and Traumatology, Muğla, Turkey.
Conference/Journal: J Orthop
Date published: 2024 Mar 13
Other: Volume ID: 54 , Pages: 86-89 , Special Notes: doi: 10.1016/j.jor.2024.03.013. , Word Count: 254


Objectives:
Some basic and instrumental daily living activities include backward gait. There is a need to clarify which parameters should be focused more on to improve backward gait in older individuals. This research investigated the proprioception, and balance in forward-backward gait of older individuals with total knee arthroplasty (TKA).

Methods:
A prospective cross-sectional research was conducted with 105 older adults with TKA. Individuals' forward and backward gait performance was assessed with the Timed Up & Go Test (TUG) and 3 Meter Walk Back Test (3MBWT), respectively. Proprioception was measured with a mobile application-based inclinometer. Berg Balance Scale (BBS) and Activity Specific Balance Confidence Scale (ABC) were used to assess balance and balance confidence levels, respectively. A single clinician evaluated the individuals.

Results:
TUG was weakly and positively correlated with the Right and Left Leg Proprioception Test (RLPT and LLPT) (r1 = 0.386, r2 = 0.391, p < 0.01). Also, the 3MBWT was weakly and positively correlated with RLPT and LLPT, respectively (r1 = 0.293, r2 = 0.251, p < 0.01). In addition, TUG was strongly and negatively correlated with BBS and ABC, respectively (r1 = -0,693, r2 = -0.722, p < 0.01). Besides, 3MBWT was strongly and negatively correlated with BBS and ABC (r1 = -0.642, r2 = -0.645, p < 0.01).

Conclusion:
The study revealed that forward and backward walking were similarly associated with balance and proprioception in older adults with TKA. Clinicians should focus more on balance ability than proprioception to improve backward walking performance in older individuals with THA.

Keywords: Backwards walking; Balance; Joint position sense; Total knee prosthesis.

PMID: 38560588 PMCID: PMC10972762 (available on 2025-08-01) DOI: 10.1016/j.jor.2024.03.013

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