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Study Design: Ex post facto research using prospective analysis of differences between the involved hip and uninvolved hip. Objectives: To assess outcomes of total hip arthroplasty (THA) by comparing range of motion (ROM), muscle strength, and postural stability in the surgical hip to those of the uninvolved hip 1 year postsurgery. An additional objective was to assess degree of relationship among ROM, strength, and postural stability impairments to a measure of self-assessed function. Background: Most patients who have THA receive physical therapy that consists mainly of self-care instructions and an exercise protocol that emphasizes mobility during the acute phase of recovery. But, outcomes of THA 1 year postsurgery indicate that current physical therapy programs used during the acute phase of recovery do not effectively restore physical and functional performance. Methods and Measures: Subjects consisted of 11 women and 4 men (mean age ± standard deviation = 62 ± 8 years) with unilateral THA performed 1 year prior to data collection. Assessment variables consisted of self-assessment of function and measures of postural stability, muscle strength, and hip ROM. The 12-Item Hip Questionnaire was used for self-assessment of function. Three separate repeated measures MANOVA were used to compare the involved side to the uninvolved side in measures of postural stability, strength, and ROM. The Spearman's rho was used to assess degree of association between the subjects' score of self-assessed function and impairments in strength and postural stability. Results: Measures of postural stability were significantly lower (P Յ 0.01) on the side of the replaced hip. Differences in strength values between the involved and uninvolved sides were not statistically significant. Correlations between scores of self-assessed function and hip abductor and knee extensor strength were statistically significant (r = 0.56, P Յ 0.03). Self-assessed function was not significantly correlated to postural stability impairments. Conclusion: The brief postsurgical rehabilitation program received by patients with THA may not be sufficient. A second phase of rehabilitation implemented 4 months or more after surgery that emphasizes weight bearing and postural stability may be advisable. J Orthop Sports Phys Ther 2002;32:260-267.

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The purpose of this study was to quantify lumbo-pelvic control differences between patients with mechanical low back pain (MLBP) and asymptomatic controls using a dynamical systems approach to data reduction and interpretations. Subjects were 30 patients with chronic MLBP (age: 41.1 ± 8.9 years, body mass index: 26.2 ± 5.2 kg/m 2 ) and 35 asymptomatic controls (age: 38.8 ± 9.2 years, body mass index: 25.3 ± 4.8 kg/m 2 ). Kinematic data were collected from the femur, pelvis and lumbar spine during repeated trials of bilateral forward reaching under two loading conditions. Sagittal plane angular motion was filtered and time normalized. Continuous relative phases were then calculated for each data point. Mean absolute relative phase (MARP) and deviation phase (DP) parameters were derived to quantify intersegmental coordination and pattern variability. Mixed-model ANOVAs revealed that lumbo-pelvic coordination was more separated in time and more variable in the chronic MLBP group during this task. Trunk neuromuscular control was thus altered in our MLBP group. Unresolved extensor muscle dysfunction is suggested by a) preliminary analysis of phase plane trajectories, b) subjects' greater difficulty controlling aspects of the task that required the extensors to contribute to trunk stability and primary movement control.

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