Improvements in balance after total hip replacement

Abstract

We have investigated whether control of balance is improved during stance and gait and sit-to-stand tasks after unilateral total hip replacement undertaken for osteoarthritis of the hip. We examined 25 patients with a mean age of 67 years (sd 6.2) before and at four and 12 months after surgery and compared the findings with those of 50 healthy age-matched control subjects. For all tasks, balance was quantified using angular measurements of movement of the trunk. Before surgery, control of balance during gait and sit-to-stand tasks was abnormal in patients with severe osteoarthritis of the hip, while balance during stance was similar to that of the healthy control group. After total hip replacement, there was a progressive improvement at four and 12 months for most gait and sit-to-stand tasks and in the time needed to complete them. By 12 months, the values approached those of the control group. However, trunk pitch (forwards-backwards) and roll (side-to-side) velocities were less stable (greater than the control) when walking over barriers as was roll for the sit-to-stand task, indicative of a residual deficit of balance. Our data suggest that patients with symptomatic osteoarthritis of the hip have marked deficits of balance in gait tasks, which may explain the increased risk of falling which has been reported in some epidemiological studies. However, total hip replacement may help these patients to regain almost normal control of balance for some gait tasks, as we found in this study. Despite the improvement in most components of balance, however, the deficit in the control of trunk velocity during gait suggests that a cautious follow-up is required after total hip replacement regarding the risk of a fall, especially in the elderly.

Impact of the method of exposure in total hip arthroplasty on balancing ability in response to sudden unidirectional perturbation in the first six months of the postoperative period

“…4 and 5). This result corresponded to previously published stance stability test results (Majewski et al, 2005;Nantel et al, 2008;Trudelle-Jackson et al, 2002). When standing on the affected limb, the compensation effect of the non-affected limb was excluded.…”

“…The back and forth and lateral motions of the COP are significantly larger than in the control group, even at 1 year after surgery (Nantel et al, 2008;Trudelle-Jackson et al, 2002). Majewski et al (2005) drew similar conclusions for body swings during gait.…”

“…deteriorated until 12 weeks after THA and remained significantly worse than the static balancing capacity of the control group even 1 year after surgery (Nantel et al, 2008;Trudelle-Jackson et al, 2002). For patients operated on using DL exposure, the dynamic balancing ability during gait was worse than that in healthy subjects even 1 year after THA (Majewski et al, 2005). No data were found in the literature on the impact of total hip arthroplasty performed using different exposure methods on the dynamic balancing ability.…”

Effect of kayaking on balancing ability after sudden changes in direction

“…20 During gait or when an external perturbation affects balance control, the risk of falling can occur. 12 There are studies that have analysed balance responses during walking on a walkway 13 and on a treadmill at a self-selected speed. 6 Few studies have examined the effect of sinusoidal moving platform translation on postural movement and stability.…”

Short-term Recovery of Balance Control after Total Hip Arthroplasty

“…Osteoarthritis of the hip results in chronic pain, reduced muscle strength, and reduced ability to perform daily activities [42,45]. Patients with degenerative hips have difficulty maintaining stability [26,32] and are at risk of falling [1,29,31,46]. Falls are a major cause of death among the elderly, with an estimated 28% of adults older than 65 years experiencing one or more falls [40].…”