Gait analysis and hip extensor function early post total hip replacement

Colgan, G.; Walsh, Mike; Bennett, Damien; Rice, John Jeremy; OʼBrien, Timothy M.

doi:10.1016/j.jor.2016.03.005

Cited by 30 publications

(23 citation statements)

References 31 publications

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“…With walking exercises using HWA, walking speed, hip joint torque, and TUG were improved early after THA. However, the gait kinematic parameters at 10 weeks after THA in our case did not return to normal levels [8]. It has been reported that improving gait kinetic and kinematic parameters is difficult [6,8,9,10,11].…”

Section: Discussionmentioning

confidence: 64%

“…Although gait function and patterns improve following THA, the functional improvements, such as gait speed, gait symmetry, and gait kinetic and kinematic parameters, are slow [4,5,6,7]. Female patients with THA walked slower than age-matched female reference subjects under maximum and normal speed conditions at about 4 weeks [4], 8 weeks [8], and even at 6 months [6] post-surgery. Furthermore, they were not able to achieve normal gait kinematic parameters, such as pelvic tilt angle, maximum hip extension angle in the stance phase, and hip flexion angle in the swing phase, compared to normal elderly subjects [6,8,9,10,11].…”

Section: Introductionmentioning

confidence: 99%

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Gait Training Using the Honda Walking Assistive Device® in a Patient Who Underwent Total Hip Arthroplasty: A Single-Subject Study

et al. 2019

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Background and objectives: The Honda Walking Assistive device® (HWA) is a light and easywearable robot device for gait training, which assists patients’ hip flexion and extension movementsto guide hip joint movements during gait. However, the safety and feasibility of robot-assisted gaittraining after total hip arthroplasty (THA) remains unclear. Thus, we aimed to evaluate the safetyand feasibility of this gait training intervention using HWA in a patient who underwent THA.Materials and methods: The patient was a 76-year-old woman with right hip osteoarthritis. Gaittraining using HWA was implemented for 20 sessions in total, five times per week from 1 week to5 weeks after THA. Self-selected walking speed (SWS), step length (SL), cadence, timed up and go(TUG), range of motion (ROM) of hip extension, and hip abduction and extension torque weremeasured preoperatively, and at 1 (pre-HWA), 2, 3, 4, 5 (post-HWA), and 10 weeks (follow-up) afterTHA. The gait patterns at SWS without HWA were measured by using three-dimensional (3D) gaitanalysis and an integrated electromyogram (iEMG). Results: The patient completed 20 gait trainingsessions with no adverse event. Hip abduction torque at the operative side, hip extension torque,SWS, SL, and cadence were higher at post-HWA than at pre-HWA. In particular, SWS, TUG, andhip torque were remarkably increased 3 weeks after THA and improved to almost the same levelsat follow-up. Maximum hip extension angle and hip ROM during gait were higher at post-HWAthan at pre-HWA. Maximum and minimum anterior pelvic tilt angles were lower at post-HWA thanat pre-HWA. The iEMG of the gluteus maximus and gluteus medius in the stance phase were lowerat post-HWA than preoperatively and at pre-HWA. Conclusions: In this case, the gait training usingHWA was safe and feasible, and could be effective for the early improvement of gait ability, hipfunction, and gait pattern after THA.

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Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Gait Training Using the Honda Walking Assistive Device® in a Patient Who Underwent Total Hip Arthroplasty: A Single-Subject Study

et al. 2019

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“…Post-operative follow-up ranged from 2 days to 6 years, with the most common time-points being 6 weeks, 3 months, 6 months, 12 months and 24 months. Only two studies 37,50 reported the radiographic severity of OA prior to surgery 93 . The direct lateral and posterior surgical approaches were the most frequently used among the included studies (n ¼ 17 and n ¼ 16, respectively), followed by the anterolateral (n ¼ 13) and direct anterior (n ¼ 10).…”

Section: Patient and Surgical Characteristicsmentioning

confidence: 99%

Biomechanical changes and recovery of gait function after total hip arthroplasty for osteoarthritis: a systematic review and meta-analysis

Bahl

Nelson

Taylor

et al. 2018

Osteoarthritis and Cartilage

107

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“…Prior research has indicated the possibility, that a damage to periarticular muscles lead to increased joint contact forces [ 16 , 26 ], however, to our best knowledge, there are no in vivo studies that correlate the hip muscle status with joint contact forces. Most analyses of the impact of muscle status on joint contact forces address gait patterns or ground reaction forces and can only extrapolate on joint forces [ 27 ]. This study aims at investigating the influence of the periarticular hip muscle status on the joint contact forces in THA patients 3 months after surgery.…”

Section: Introductionmentioning

confidence: 99%

Gluteal muscle damage leads to higher in vivo hip joint loads 3 months after total hip arthroplasty

et al. 2018

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BackgroundTotal hip arthroplasty (THA) is in most cases improving patients´ life quality immediately after surgery. However, a closer look at these patients, especially with modern gait analysis methods, reveals also negative consequences due to the surgical approach related injury to the pelvic muscles. We hypothesized that this damage will have a negative impact on hip joint contact forces during activities of daily living (ADL).Methods10 patients undergoing THA received an instrumented hip joint implant enabling real time in vivo measurements of hip joint loads using a direct lateral approach. Pre- and 3 months postoperative computed tomography (CT) scans were used for evaluation of the periarticular muscle status, using muscle volume, fat ratio and lean muscle volume as parameters. An analysis of in vivo hip contact forces was made 3 months after THA during ADL (walking, stair climbing, chair rising and sitting) and correlated with the morphology of the periarticular muscles.ResultsWe found a significant decrease of volume by 25% (-3 to -45, p = 0.005) and increase in fat ratio of the Gluteus Minimus (Gmin), resulting in a decrease in lean muscle volume of 28% (-48 to 0, p = 0.008). This was accompanied by an inverse development in the Tensor Fasciae Latae (TFL) resulting in a lean muscle volume increase of 34% (-2 to -102, p = 0.013). Changes in Gluteus Medius (Gmed) and Gluteus Maximus (Gmax) have not been observed in the short-term follow up. A decreased Gmin lean muscle volume was found to strongly correlate with high in vivo joint contact forces in all tested ADL.ConclusionThe decrease of Gmin volume can be seen as a direct effect of THA surgery, whereas the increase of TFL might compensate for loss of Gmin volume. Lean muscle volume and fat ratio were better predictors for joint contact forces than total muscle volume. These effects were most pronounced during sitting down and standing up due to the higher demand on the gluteal muscles during these activities.

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Gait analysis and hip extensor function early post total hip replacement

Cited by 30 publications

References 31 publications

Gait Training Using the Honda Walking Assistive Device® in a Patient Who Underwent Total Hip Arthroplasty: A Single-Subject Study

Gait Training Using the Honda Walking Assistive Device® in a Patient Who Underwent Total Hip Arthroplasty: A Single-Subject Study

Biomechanical changes and recovery of gait function after total hip arthroplasty for osteoarthritis: a systematic review and meta-analysis

Gluteal muscle damage leads to higher in vivo hip joint loads 3 months after total hip arthroplasty

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