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

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.