Isokinetic Performance After Total Hip Replacement

Bertocci, Gina; Munin, Michael C.; Frost, Karen; Burdett, Ray G.; Wassinger, Craig A.; Fitzgerald, Shirley G.

doi:10.1097/01.phm.0000098047.26314.93

Cited by 79 publications

(75 citation statements)

References 16 publications

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“…These findings are important because they indicate a substantial deficit in isometric strength in THA subjects compared with community-dwelling older adults at a time shortly after the subjects had completed rehabilitation. Despite patient self-reports of decreased pain and improved function relative to presurgical levels [27][28], our current and previous findings [10] and those of Reardon et al [8] and others [29] suggest that compared with community-dwelling older adults, THA subjects continue to experience strength deficits. THA subjects' hip strength was only 60 percent of that generated by community-dwelling older adults in flexion and 87 percent and 84 percent of the strength generated by community-dwelling older adults in extension and abduction, respectively.…”

Section: Discussioncontrasting

confidence: 39%

“…Studies based on selfreport data indicate that THA successfully alleviates pain and improves function relative to presurgical levels [4][5][6]. However, studies based on objective performance-based measures indicate that despite postoperative improvements, THA subjects continue to exhibit deficits in strength [7][8][9][10], postural stability [2], and gait [11].…”

Section: Introductionmentioning

confidence: 97%

“…THA subjects participated between 4 and 5 months postsurgery. As indicated previously [10], this time period was chosen for several reasons: (1) postoperative healing was significantly complete, (2) hip range of motion (ROM) precautions were typically relaxed by the orthopedic surgeon, (3) risk of dislocation was significantly reduced, (4) patients had resumed activities of daily living, and (5) patients were able to execute the tests included in the study protocol. We recruited 22 THA subjects and 38 communitydwelling older adults.…”

Section: Subjectsmentioning

confidence: 99%

“…Compared with communitydwelling older adults, patients in Reardon's study had significantly reduced quadriceps concentric peak torque (p < 0.008) but no difference in eccentric peak torque. Bertocci et al evaluated isokinetic flexion, extension, and abduction performance in months 4 and 5 following surgery and compared THA subject performance with community-dwelling older adults [10]. THA subject operated versus nonoperated hips showed no significant differences in isokinetic performance for any of the examined variables; however, compared with community-dwelling older adults, THA subjects generated significantly less peak torque and work across all test conditions [10].…”

Section: Introductionmentioning

confidence: 99%

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Isometric performance following total hip arthroplasty and rehabilitation

Frost¹,

Bertocci²,

Wassinger³

et al. 2006

JRRD

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Abstract-We compared differences in isometric strength between older adults who have undergone elective unilateral total hip arthroplasty (THA) and completed rehabilitation with a population of community-dwelling older adults who have not had THA. The study was a cross-sectional design, and 22 unilateral THA subjects and 38 community-dwelling older adults participated. THA subjects received on average 13 outpatient or home-based physical therapy sessions before evaluation. THA subjects were evaluated 4 to 5 months postsurgery. We assessed isometric muscle strength by measuring peak hip torque per body weight with a robotic dynamometer during abduction, flexion, and extension. No significant performance differences were observed between operated and nonoperated hips of THA subjects. THA subject operated and nonoperated hips generated significantly less peak torque per body weight during flexion (p = 0.03) compared with community-dwelling older adult hips (THA subject operated hips = 6.96 ft-lb/lb, THA subject nonoperated hips = 8.26 ft-lb/lb, communitydwelling older adult hips = 11.56 ft-lb/lb). No significant differences were observed between THA subjects and community-dwelling older adults during hip extension (p = 0.55) or abduction (p = 0.17). At 4 to 5 months postsurgery, THA subjects were not at the same level of biomechanical performance as community-dwelling older adults. Significant strength deficits were found in THA subject operated versus nonoperated hips during isometric flexion. Additional or modified physical therapy that targets the hip flexors is recommended after THA.

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Section: Discussioncontrasting

confidence: 39%

Section: Introductionmentioning

confidence: 97%

Section: Subjectsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Isometric performance following total hip arthroplasty and rehabilitation

Frost¹,

Bertocci²,

Wassinger³

et al. 2006

JRRD

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“…However, self-reported quality of life after THA may begin to decline as early as 18 months after THA [33] and functional mobility deficits persist several years after surgery [3,29,43,53]. Therefore, the full recovery of functional mobility for individuals after THA may be a challenge in rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Muscle Strength and Functional Recovery During the First Year After THA

Judd¹,

Dennis

Thomas³

et al. 2013

Clin Orthop Relat Res

146

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Background Patients undergoing total hip arthroplasty (THA) often are satisfied with the decrease in pain and improvement in function they achieve after surgery. Even so, strength and functional performance deficits persist after recovery, but these remain poorly characterized; knowledge about any ongoing strength or functional deficits may allow therapists to design rehabilitation programs to optimize recovery after THA. Questions/purposes The purposes of this study were to (1) evaluate postoperative muscle strength, function, and quality of life during the first year after THA; and (2) compare strength and function in patients 1 year after THA with a cohort of healthy peers. Methods Twenty-six patients undergoing THA were assessed 1, 3, 6, and 12 months postoperatively, and 19 adults with no hip pathology were tested as a control group. Isometric muscle strength (hip flexors, extensors, abductors, knee extensors, and flexors), functional performance (stair climbing, five times sit-to-stand, timed-up-and-go, 6-minute walk, and single-limb stance tests), and selfreported function (Hip Disability and Osteoarthritis Score, SF-36, and UCLA activity score) were compared. Results One month after THA, patients had 15% less hip flexor and extensor torque, 26% less abductor torque, 14% less knee extensor and flexor torque, and worse performance on the stair climbing, timed-up-and-go, single-limb stance, and 6-minute walk. Compared with healthy adults, patients 12 months after THA had 17% less knee extensor and 23% less knee flexor torque; however, the functional testing (including stair climbing, five times sit-to-stand, and the 6-minute walk) showed no significant differences with the patient numbers available between individuals undergoing THA and healthy control subjects. SF-36 Physical Component Scores, although significantly improved from preoperative levels, were significantly worse than healthy adults 1 year after THA (p \ 0.01).

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Rehabilitation Biomechanics

Koontz

McCrory

Cham

et al. 2006

Wiley Encyclopedia of Biomedical Engineering

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Rehabilitation biomechanics is a field of study that addresses the impact of disability and the effectiveness of rehabilitation therapies and interventions on human performance. Engineering and physics principles are applied to evaluate and analyze body movement and manipulation. This article describes biomechanical evaluation as a clinical and research tool for assessing the effect of disability on task performance, evaluating the risk of injury, and optimizing the fit of an assistive device to an individual. Methods and tools for measuring human kinematics, kinetics, energy expenditure, and muscle activity in rehabilitation applications are presented in addition to the use of biomechanical models and computer simulation as tools to determine parameters that cannot be measured with current technology or are difficult to measure directly. An introduction to gait analysis is reviewed with specific examples of cases where biomechanical analyses have led to new knowledge and improvements in clinical practices. Lastly, future trends and needs in rehabilitation biomechanics applications and research are discussed in relation to the increasing age of the population and persons aging with a disability.

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Isokinetic Performance After Total Hip Replacement

Cited by 79 publications

References 16 publications

Isometric performance following total hip arthroplasty and rehabilitation

Isometric performance following total hip arthroplasty and rehabilitation

Muscle Strength and Functional Recovery During the First Year After THA

Rehabilitation Biomechanics

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