Influence of Upper Extremity Assistance on Lower Extremity Force Application Symmetry in Individuals Post-Hip Fracture During the Sit-to-Stand Task

Kneiss, Janet A.; Houck, Jeff; Bukata, Susan V.; Puzas, J. Edward

doi:10.2519/jospt.2012.3562

Cited by 11 publications

(18 citation statements)

References 25 publications

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“…This indicates an asymmetric pattern during the dynamic balance control of OA patients, putting more weight on the non-affected leg while they are performing the STS task, while the distribution of weight in both, involved and uninvolved limbs, during quiet standing appears to be symmetric in the vertical direction. This preference for the uninvolved side does not depend on upper extremity assistance [26]. This result is comparable with the result of Nederhand et al and van Asseldonk et al in stroke patients that showed dynamic balance control provides more information about the stabilizing mechanism than static weight distribution [42], [43].…”

Section: Discussionsupporting

confidence: 85%

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Preoperative Ambulatory Measurement of Asymmetric Leg Loading During Sit-to-Stand in Hip Arthroplasty Patients

Martínez-Ramírez

Weenk

Lecumberri

et al. 2014

IEEE Trans. Neural Syst. Rehabil. Eng.

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Total hip arthroplasty (TGA) is a successful surgical procedure to treat patients with hip osteoarthritis. Clinicians use different questionnaires to evaluate these patients. Gait velocity and these questionnaires; usually show significant improvement after TGA . This clinical evaluation does, however, not provide objective, quantifiable information about the movement patterns underlying the functional capacity, which is clinically important and can currently only be obtained in a gait laboratory. There is a need to improve patient instructions and to quantify the rehabilitation process. The sit-to-stand (STS) movement is an objective performance-based task, whose assessment is related with the evaluation of functional recovery. Twenty two patients with hip osteoarthritis participated in this study. For each patient, validated questionnaires were administered and gait velocity was measured. Time, ground reaction forces, and lower limb asymmetry parameters were calculated using the instrumented force shoes (IFS) during STS movement with and without armrest. Significant inter-limb asymmetry was observed. No correlation was found between any parameter and gait velocity and questionnaires outcomes. Significant differences in time and force parameters between with/without armrest were found. Concluding, inter-limb asymmetry can be evaluated with the IFS supplying important additional information not represented by gait velocity and questionnaires usually used.

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Section: Discussionsupporting

confidence: 85%

“…Some individuals are unable to rise from a chair without using the armrests, which decreases the force required by the lower extremities and/or provides stability [26].…”

Section: Introductionmentioning

confidence: 99%

Preoperative Ambulatory Measurement of Asymmetric Leg Loading During Sit-to-Stand in Hip Arthroplasty Patients

Martínez-Ramírez

Weenk

Lecumberri

et al. 2014

IEEE Trans. Neural Syst. Rehabil. Eng.

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“…The mechanism for the occurrence of persistent pain after hip fracture might include restriction in weight bearing and disuse of the affected limb. Hip fracture decreases lower extremity muscle strength, especially in the fractured leg, which leads to asymmetrical muscle strength and power deficit . Shortening of the limb length and limitations in the range of motion have been reported to be more common after internal fixation than after arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Type of surgery is associated with pain and walking difficulties among older people with previous hip fracture

Salpakoski

Kallinen

Kiviranta

et al. 2015

Geriatrics Gerontology Int

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“…Although few longitudinal studies have evaluated movement patterns before and after TKA, some evidence suggests that asymmetries that reduce reliance on the operated limb are adopted in the presence of pain and weakness before TKA and persist after surgery, despite traditional rehabilitation. 15 This finding is not isolated to individuals post-TKA; Kneiss et al 12 reported that patients post–hip fracture demonstrated interlimb asymmetrical loading patterns during a sit-to-stand (STS) task, even after discharge from rehabilitation. 22 In addition to the potential negative consequences of movement asymmetries on contralateral joint loading, greater asymmetry is also related to worse functional performance.…”

mentioning

confidence: 99%

Biofeedback to Promote Movement Symmetry After Total Knee Arthroplasty: A Feasibility Study

Zeni

Abujaber²,

Flowers³

et al. 2013

Journal of Orthopaedic & Sports Physical Therapy

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STUDY DESIGN Prospective analysis of a longitudinal cohort with an embedded comparison group at a single time point. OBJECTIVES To determine the feasibility and effectiveness of an outpatient rehabilitation protocol that includes movement symmetry biofeedback on functional and biomechanical outcomes after total knee arthroplasty (TKA). BACKGROUND TKA reduces pain and improves functional ability, but many patients experience strength deficits and movement abnormalities in the operated limb, despite outpatient rehabilitation. These asymmetries increase load on the nonoperated limb, and greater asymmetry is related to worse functional outcomes. METHODS Biomechanical and functional metrics were assessed 2 to 3 weeks prior to TKA, at discharge from outpatient physical therapy, and 6 months after TKA in 11 patients (9 men, 2 women; mean ± SD age, 61.4 ± 5.8 years; body mass index, 33.1 ± 5.4 kg/m2) who received 6 to 8 weeks of outpatient physical therapy that included specialized symmetry training. Six-month outcomes were compared to a control group, matched by age, body mass index, and sex (9 men, 2 women; mean ± SD age, 61.8 ± 5 years; body mass index, 34.3 ± 5.1 kg/m2), that did not receive specialized symmetry retraining. RESULTS Of the 11 patients who received added symmetry training, 9 demonstrated clinically meaningful improvements that exceeded the minimal detectable change for all performance-based functional tests at 6 months post-TKA compared to pre-TKA. Six months after TKA, when walking, patients who underwent symmetry retraining had greater knee extension during midstance and had mean sagittal knee moments that were more symmetrical, biphasic, and more representative of normal knee kinetics compared to patients who did not undergo symmetry training. No patients experienced adverse events as the result of the protocol. CONCLUSION Adding symmetry retraining to postoperative protocols is clinically viable, safe, and may have additional benefits compared to rehabilitation protocols that focus on range of motion, strength, and return to independence.

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Influence of Upper Extremity Assistance on Lower Extremity Force Application Symmetry in Individuals Post-Hip Fracture During the Sit-to-Stand Task

Cited by 11 publications

References 25 publications

Preoperative Ambulatory Measurement of Asymmetric Leg Loading During Sit-to-Stand in Hip Arthroplasty Patients

Preoperative Ambulatory Measurement of Asymmetric Leg Loading During Sit-to-Stand in Hip Arthroplasty Patients

Type of surgery is associated with pain and walking difficulties among older people with previous hip fracture

Biofeedback to Promote Movement Symmetry After Total Knee Arthroplasty: A Feasibility Study

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