Gait Analysis After Reverse Total Shoulder Arthroplasty

Shoulder pain in older adults is associated with reduced mobility and impaired quality of life. Reverse total shoulder arthroplasty (RTSA) reliably improves shoulder pain and function; however, its effect on whole-body function, particularly gait and trunk stability, has not been fully elucidated. We aimed to investigate longitudinal changes in gait performance and trunk stability following RTSA using triaxial accelerometer-based gait analysis.

This retrospective observational case series included 32 patients (3 male and 29 female; mean age, 77.5 ± 8.1 years) who underwent RTSA and gait analysis preoperatively and postoperatively at 1 week, 1 month, and/or 3 months. Gait analysis was performed under normal and maximum-speed walking conditions using a triaxial accelerometer attached to the third lumbar vertebra. Temporal and spatial gait parameters and trunk acceleration-based indices, including root mean square (RMS), velocity-corrected RMS (RMS*), and the symmetry index (SI), were evaluated. Paired t-tests and linear mixed-effects models were used for statistical analyses.

During normal walking, trunk acceleration indices (RMS in all axes, resultant RMS, and RMS*) significantly decreased from 1 month postoperatively, whereas walking time significantly decreased and stride length increased from 1 month postoperatively, indicating early improvement in temporal and spatial gait parameters. During maximum-speed walking, significant reductions in trunk acceleration indices and improvements in the SI were observed at 3 months postoperatively. Linear mixed-effects model analysis demonstrated significant postoperative improvements in walking speed, stride length, walking time, walking cycle, and trunk stability indices. Improvements in gait stability preceded or paralleled improvements in gait efficiency.

RTSA was associated with reductions in trunk acceleration variability (RMS and RMS*) and improvements in gait efficiency, with changes emerging by 1 month during normal walking and by 3 months during maximum-speed walking. These findings suggest that RTSA may contribute to improved whole-body gait control in addition to restoring shoulder function.

Level IV, therapeutic case series. See Instructions for Authors for a complete description of levels of evidence.