BACKGROUND Patients with chronic ankle instability (CAI) can present with abnormal gait. The purpose of this study was to evaluate plantar pressure distributions and posture balance during walking in unilateral CAI patients. MATERIAL AND METHODS We recruited 24 unilateral CAI patients and 24 healthy individuals; plantar pressure analysis was conducted using the Footscan® 3D pressure system. The following parameters were assessed and recorded: peak force/weight (PF/W), time to peak force (TPF), time to boundary (TTB), and COP velocity. The differences between the affected and unaffected side of the CAI group and control group were determined. Pearson correlation analysis and univariate analysis was used to investigate the correlation between plantar pressure parameters and related factors. RESULTS The comparison of PF/W showed that the plantar pressure of both sides in the CAI group were laterally distributed. The comparison of TPF, TTB, and COP velocity in different groups showed that the posture balance on the affected side of CAI patient was more impaired than the unaffected side and the control group. Male patients with CAI tend to have better posture balance than females, and a low CAIT score is correlated with poor posture balance. CONCLUSIONS The plantar pressure on both sides in unilateral CAI patients was laterally distributed and their balance function was impaired. It is necessary for CAI patients to receive functional training of both sides during rehabilitation, and plantar pressure analysis is promising for diagnosis and evaluation of CAI.

Background: Total knee arthroplasty (TKA) is a surgical procedure primarily used to treat patients with end-stage knee osteoarthritis (KOA). Postoperative physical exercise is a critical part of the overall treatment of KOA and can bring significant benefits to the patients' recovery. Wearable devices can monitor patients' exercise data and upload it to the physician's workstation. This allows the rehabilitation physician to make timely adjustments based on the patients' movement feedback, and the surgeon can be informed of the patients' functional status. Overall, this study aims to evaluate the effectiveness of using wearable monitoring devices for rehabilitation exercise after TKA, with a focus on cost, time savings, and patient outcomes. Method/design: This is a single-center, single-blinded, parallel randomized controlled trial conducted at Xi'an Honghui Hospital, a regional orthopedic medical center. Eligible patients will be recruited to participate in the study, and baseline data collection and clinical assessments will be conducted at the time of admission. Using the principle of random allocation, recruited patients will be divided into either the experimental or control group. Both groups will undergo a standard, widely promoted rehabilitation program. The patients in the experimental group will wear equipment to detect and track mobility in the lower limbs. All patients will return to the outpatient clinic for follow-up assessments at 2 weeks, 12 weeks, and 24 weeks after discharge, where outcome indicators will be measured. The primary outcome will be the cost and time after discharge, while secondary outcomes will include the 6-min walk test (6MWT), range of motion (ROM), visual analog scale (VAS), American Knee Society Score (KSS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Discussion: We should encourage the adoption of novel, easy-to-use, supervised devices if they prove to be beneficial for patients in terms of cost, time, and effectiveness after TKA. This type of device is particularly important for people in remote rural areas, those with limited financial resources, and those who are reluctant to return to hospitals for follow-up care. Trial registration Chinese Clinical Trial Registry ChiCTR2300068418. Registered on 17 February 2023.

Purpose: Frailty is a difficult-to-measure condition that is susceptible to adverse outcomes. The Japan Frailty Scale (JFS) is a tool for assessing frailty status in older adults. This study aimed to translate and culturally adapt the JFS into a Chinese version (JFS-C).Materials and methods: The study included 160 older adults as participants. Internal consistency was assessed using Cronbach’s alpha, and test–retest reliability was conducted using the intraclass correlation coefficient (ICC). Convergent validity was evaluated by assessing the correlation between JFS-C and the Barthel Index, the Frail scale, and the 36-item Short-Form Health Survey (SF-36). Criterion validity was assessed by comparing JFS-C scores with the Frail scale.Results: JFS-C demonstrated adequate internal consistency (Cronbach’s alphas = 0.711) and excellent test–retest reliability over a 7 to 10-day interval (ICC = 0.949). Correlation analysis showed a strong positive correlation between JFS-C and the Frail scale (r = 0.786, p < 0.001), a moderate negative correlation with the Barthel Index (r = −0.598, p < 0.001), and moderate correlations with various subscales of SF-36 (r = −0.574 to −0.661). However, no significant correlations were found between JFS-C and SF-36 mental health (r = −0.363, p < 0.001) or role emotional (r = −0.350, p < 0.001). Based on the reference standard of the Frail scale phenotype (score ≥ 2), the cutoff value for JFS-C was determined to be 3.Conclusion: JFS-C demonstrates good reliability and validity in assessing frailty among the older population in China.

Purpose Patient-reported outcome measures (PROMs) are being used more frequently in total knee arthroplasty (TKA). By utilizing high-quality scales, surgeons can achieve a more comprehensive and accurate evaluation of the effectiveness of TKA surgery. Currently, there is no widely accepted conceptual model for TKA PROMs. The objective of this study is to fill this gap by developing a conceptual model and preliminary content for a PROM that is specifically designed for TKA patients in mainland China. Methods The study design consisted of three stages: (1) a targeted literature review followed by the formation of a conceptual model pool; (2) qualitative data collection involving experts and patients, leading to the development of the preliminary Chinese TKA PROM (CTP); and (3) review of the CTP by experts using the Delphi method, along with cognitive debriefing interviews with patients. Results 64 patients and 28 experts took part in this study. The conceptual model focused on six key concepts: pain, symptom, function, quality of life, expectation, and satisfaction. To match the model, the authors developed a total of 35 items. Conclusion A conceptual model and preliminary content for CTP was developed with substantial participation from patients and a multidisciplinary group of experts. The integration of patient and clinical perspectives ensured a comprehensive representation of all relevant disease experiences and the focus of clinical practice. With further refinement through psychometric testing, the CTP is positioned to provide a standardized, comprehensive measure for research specific to Chinese TKA patients.

Objective: To develop a culturally adapted assessment tool for evaluating one-year postoperative knee function in Chinese patients after total knee arthroplasty (TKA), and to establish foundations for localized evaluation protocols and early postoperative interventions. Methods: This cross-sectional study systematically reviewed knee function assessment items for post-TKA patients. Based on expert and patient focus group discussions, a set of evaluation items was established, followed by designing a self-administered questionnaire assessing importance, frequency, and difficulty. From February to December 2024, TKA patients at 1 year post-surgery and age-matched healthy controls were recruited at Honghui Hospital, Xi’an, China. High-frequency activities were identified and compared between groups. Results: A total of 39 culturally relevant knee function items were developed through expert and patient consensus. The study included 713 TKA patients and 675 age-matched healthy controls, and 14 high-frequency activities were identified based on importance ratings. No significant functional differences were observed between TKA patients and controls in individuals under 65 years. In the 65–75-year group, only females showed decreased performance in picking up items from the ground ( p < 0.001). Among participants older than 75 years, males showed significant deficits in putting on and taking off shoes and socks ( p = 0.008), squatting ( p < 0.001), picking up items from the ground ( p = 0.009), and carrying heavy objects with one hand ( p < 0.001), while females demonstrated reduced ability in bathing and wiping ( p < 0.001), picking up items from the ground ( p < 0.001), and squatting ( p = 0.048). Conclusion: Most patients regain daily function 1 year after TKA, but limitations persisted in older patients. The 14 culturally relevant activities identified provide a practical basis for a localized assessment. Future work will involve longitudinal validation and clinical integration to support individualized postoperative rehabilitation.

The 2011 Knee Society Score (new-KSS) describes symptom, satisfaction, expectation, and functional activities in patients undergoing total knee arthroplasty (TKA) and is widely recognized for assessing TKA outcomes. Before using this scale in non-English-speaking populations, it must be translated and culturally adapted to suit the specific demographic. The new-KSS was translated and culturally adapted into the new-KSS-CV following international guidelines. Item modifications were informed by the Chinese TKA PROM (CTP), a Delphi expert consensus and cognitive interviews with Chinese TKA patients, aiming to reflect local cultural and activity patterns. The adapted scale was applied in a validation study with preoperative and one-year postoperative assessments. Reliability was assessed using intraclass correlation coefficient (ICC) and Cronbach's α. Construct validity was tested by comparing the new-KSS-CV with the Chinese versions of the WOMAC and SF-12. Responsiveness was determined by calculating the standardized response means (SRM). A total of 226 patients were included, with a mean age of 64.7 ± 5.7 years; 142 (62.8%) were female. All patients completed both preoperative and one-year postoperative assessments. Ceiling effects were observed preoperatively in the expectation dimension (40.7% of patients) and postoperatively in symptom (54.4%), functional (72.1%), and standard activities (19.0%) domains. The new-KSS-CV showed good to excellent test-retest reliability (ICC: 0.88-0.97) and internal consistency (Cronbach's α: 0.74-0.85). The total score correlated significantly and moderately negatively with WOMAC (r = -0.68, p < 0.001), while the symptom (r = -0.41), satisfaction (r = -0.42), and functional activities (r = -0.66) domains also showed significant weak to moderate negative correlations (all p < 0.001). The expectation domain showed a very weak but significant positive correlation (r = 0.19, p = 0.005). The functional activities domain and total score of the new-KSS-CV correlated significantly and positively with the SF-12 physical component (r = 0.57 and 0.50, respectively; p < 0.001). The new-KSS-CV demonstrated a higher SRM (3.89) than WOMAC (-2.41) and SF-12 (1.69 and 0.33). The new-KSS-CV is a reliable, valid, responsive, and consistent outcome measurement tool that can be used to evaluate the outcome of TKA in Chinese patients.