The Influence of Visual Feedback on the Mental Representation of Gait in Patients with THR: A New Approach for an Experimental Rehabilitation Strategy

Abstract

Due to total hip replacement (THR), patients reveal abnormal gait patterns which post-operative do often not return to "normal". The restoration towards normal gait reduces stress on the adjacent joints which consequently reduces risk of osteoarthrosis development. Motor-performance is related to the structure of the movement in long-term memory, thus it seems to be essential to imprint correct gait patterns in there. Mental representation structures can develop over the course of training and visual feedback presumably helps regaining a better representation of gait in long-term memory. The purpose of this study is to evaluate the effect of visual feedback on mental representation in patients with THR. In a randomized controlled trial, 20 women (57 ± 6 years) with THR have been enrolled. Subjects were randomly assigned to a control group (CG) or intervention group (IG). Additionally to inpatient treatment, all subjects participated in a standardized gait training including either an intervention based on verbal information from a physiotherapist (CG) or an intervention based on real-time visual feedback (IG). Mental representation was measured in pre-test and post-test using the structure-dimensional analysis. Results indicate significant improvements in mental representation of gait in the post-test only in IG, suggesting that beneficial effects were provoked by visual feedback.

Qualitative analysis of foot intersegment coordination in the sagittal plane following surgery for end-stage ankle osteoarthrosis

“…Furthermore, studies have also shown the importance of gait modification strategies to reduce gait deviation, as much as possible, following surgical corrections. This can be done using real‐time movement feedback . Continuous gait assessment based on the intersegment coordination using wearable sensors could help improve rehabilitation by helping patients learn the most efficient gait pattern which could benefit not just the operated but the surrounding joints.…”

The Representation of Motor (Inter)action, States of Action, and Learning: Three Perspectives on Motor Learning by Way of Imagery and Execution

“…Results elicited that skilled individuals held functionally structured representations relating well to the biomechanical demands of the task (i.e., reflecting clearly the three movement phases pre-activation, strike, and final swing), whereas unskilled individuals’ representations were unstructured. This has been shown to generalize to motor skills of different complexities (e.g., manual action: Braun et al, 2007; gait: Schega et al, 2014; Stöckel et al, 2015; dance: Bläsing, 2010). …”

Toward a Design of a Telerehabilitation Program for the Functional Recovery in Post-Hip Arthroplasty Patients

“…For instance, there is Trendelemburg sign with a pelvis tilt towards the limb where the load is. This alteration is especially due to the gluteus medius dysfunction, which is severely affected during surgery [54]. The gait reeducation aims to recover the normal movement pattern.…”

“…The Kinect camera was used as a natural user interface to capture some exercises performed by patients. The movement quality was evaluated in real time by an assessment module implemented according to a Hidden-Markov Model Components and sub-components for the stage 2 [48][49][50][51][52][53][54][55].…”