Impact of Sarcopenia and Obesity on Gait Speed After Total Knee Replacement |
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| Institution: | 1. Master Program in Long-Term Care, Taipei Medical University, College of Nursing, Taipei, Taiwan;2. Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan;3. Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;4. Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan;5. Department of Orthopedic Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan;6. Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;1. NYU Long Island School of Medicine, Mineola, NY, USA;2. NYU Langone-Long Island Hospital, Mineola, NY, USA;1. Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore;2. Department of General Surgery, Singapore General Hospital, Singapore;3. Department of Emergency Medicine, Singapore General Hospital, Singapore;4. Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore;5. Trauma Service, Tan Tock Seng Hospital, Singapore;6. Department of General Surgery, National University Hospital, Singapore;7. Accident & Emergency, Changi General Hospital, Singapore;8. Department of General Surgery, Khoo Teck Puat Hospital, Singapore;9. Emergency Medicine Department, Ng Teng Fong General Hospital, Singapore;10. Department of Geriatric Medicine, Singapore General Hospital, Singapore;11. School of Pharmacy, Memorial University of Newfoundland, Canada, St. John''s, Newfoundland, Canada;12. Department of Rehabilitation Medicine, Singapore General Hospital, Singapore;13. Centre for Ageing Research and Education, Duke-NUS Graduate Medical School, Singapore;14. Department of Vascular Surgery, Singapore General Hospital, Singapore;1. Division of Internal and Post-Surgical Medicine, Azienda Ospedaliero-Universitaria Careggi and University of Florence, Florence, Italy;2. Division of Geriatric Medicine and Cardiology, Azienda Ospedaliero-Universitaria Careggi and University of Florence, Florence, Italy;3. Agency for Postdischarge Continuity of Care, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy;4. Clinical Risk Management and Patient Safety Centre, Tuscany Region, Italy;5. Intensive Care Unit and Regional ECMO Referral Centre Emergency Department Azienda Ospedaliero-Universitaria Careggi, Florence, Italy |
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| Abstract: | ObjectivesOlder adults with sarcopenic obesity have a higher risk of experiencing mobility difficulty. Additionally, sarcopenia and obesity are closely associated with knee osteoarthritis. This study investigated the associations of sarcopenia, obesity, and in combination of both with walking disability during postoperative rehabilitation in older adults with knee osteoarthritis who underwent total knee replacement.DesignA retrospective cohort study.Setting and ParticipantsFrom a rehabilitation center database, we retrospectively selected and investigated 482 older patients with knee osteoarthritis who had undergone total knee replacement and received postoperative rehabilitation.MethodsSarcopenia was identified in accordance with the diagnostic criteria established by the Asian Working Group for Sarcopenia and obesity was defined as body mass index ≥ 30 kg/m2. Accordingly, patients were classified into four body composition groups, namely sarcopenic obese, sarcopenic, obese, and normal (reference group). After total knee replacement, all patients attended monthly follow-up admission during the postoperative rehabilitation. Gait speed was measured before surgery and monthly after total knee replacement. A gait speed cutoff of 1.0 m/s was used to identify postoperative walking disability. Kaplan–Meier curve analysis was performed to measure the probability of experiencing postoperative walking disability among the groups. Cox multivariate regression models were established to calculate the hazard ratios of postoperative walking disability.ResultsCompared with the reference group, the sarcopenic, obese, and sarcopenic obese groups appeared to have a higher probability of experiencing postoperative walking disability (all P < .001). The sarcopenic obese group were likely to have the highest risk of experiencing postoperative walking disability (adjusted hazard ratio = 3.89).Conclusions and ImplicationsSarcopenia or obesity alone may independently exert negative effects on postoperative gait speed. The participants with sarcopenic obesity were likely to have the highest risk of experiencing walking disability following total knee replacement. The findings may serve as a reference for clinicians developing rehabilitation strategies to optimize walking ability after total knee replacement, especially those preoperatively diagnosed as having sarcopenic obesity. |
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| Keywords: | Sarcopenia obesity osteoarthritis total knee replacement mobility |
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