In vivo loading on the hip joint in patients with total hip replacement performing gymnastics and aerobics exercises

Abstract

A further increase in the number of total hip arthroplasty (THA) is predicted, in particular the number of young THA patients has raised and with it their demands. There is no standardized evidence-based rehabilitation program and no reliable guidelines for sports activities after THA. Stretching and strengthening gymnastics are routinely performed in rehabilitation and aerobics as a sport after THA. The aim of the investigation was to determine the in vivo force and moments acting on the hip prosthesis during gymnastics and aerobic exercises to provide a source for evidence-based recommendations. Hip joint loads were measured in six patients with instrumented hip implants. The resulting force FRes, bending moment MBend at the neck and torsional moment MTors at the stem were examined during seven strengthening (with two different resistance bands) and four stretching gymnastic exercises and seven aerobic exercises with and without an aerobic step board compared to the loads during the reference activity walking. The stretching and strengthening gymnastics exercises and the aerobic exercises with and without a board demonstrated in their median peak force and moments mostly lower or similar values compared to walking. Significantly increased loads were recorded for the flexor stretching exercise in monopod stand (Fres and MBend), the strengthening abduction exercise on the chair (MTors) and the strengthening flexion exercise with the stronger resistance band (MTors). We also found a significant increase in median peak values in aerobic exercises with a board for the "Basic Step" (ipsilateral started Fres and MTors; contralateral started MTors), "Kickstep ipsilateral started" (Fres and MTors) and "Over the Top contralateral started" (Fres). The in vivo loads in THA patients during frequently performed stretching, strengthening and aerobic exercises were demonstrated for the first time. It was proved that stretching gymnastic exercises are safe in terms of resulting force, bending and torque moments for THA patients, although an external assistance for stabilization may be considered. Strengthening gymnastics exercises are reliable in terms of Fres, MBend and MTors, but, based on our data, we recommend to adhere to the communicated specific postoperative restrictions and select the resistance bands with lower tension. Aerobic exercises without an aerobic board can be considered as reliable activity in terms of force and moments for THA patients. Aerobic exercises with a board are not recommended for the early postoperative period and in our opinion need to be adapted to the individual muscular and coordinative resources.

Is Training With Gym Machines Safe After Hip Arthroplasty?—An In Vivo Load Investigation

“…Overall, F res and M bend during single-leg stance were distinctly higher in the exercises performed with the contralateral leg compared to the rope pull exercises performed ipsilaterally (standing on the instrumented hip prosthesis, named ipsilateral). This indicates the exceptional load on the prosthesis during monopod standing and has been reported in other studies ( Haffer et al, 2021 ). The flexion and abduction movement with the rope pull machine with the contralateral leg increases the lever arm.…”

Effects of Incontro, Alleanza, Responsabilita, Autonomia Intervention Model Combined with Orem Self-Care Model and the Use of Smart Wearable Devices on Perceived Stress and Self-Efficacy in Patients after Total Hip Arthroplasty

“…Among them, items 1–4 and 8–10 all adopt 1–4 Likert 4 score. Other items are scored according to the selection, the higher the score, the higher the level of social support, 22 points are the critical value [ 7 , 8 ].…”

“…The other nursing theory, called Orem self-care model, was put forward by Dorothea Elizabeth Orem, Master of Nursing Education in the United States [ 7 ]. It was gradually applied to clinical practice guidance, education, and research in China in the mid-1980s.…”

“…It was gradually applied to clinical practice guidance, education, and research in China in the mid-1980s. It includes self-care theory, self-care defect theory, and nursing system theory [ 7 ]. It is widely used in the nursing care of elderly patients undergoing THA.…”

Overstretching Expectations May Endanger the Success of the “Millennium Surgery”

“…The in vivo loads during sporting activities were mostly unknown, except for those activities measured in our small cohort of patients ( Kutzner, et al, 2017 ; Damm et al, 2017 ; Kutzner et al, 2017 ; Haffer et al, 2021 ). However, there is evidence that joint friction differed markedly between ADL and sports activities ( Georg Bergmann, et al, 2018a ).…”