Vertical ground reaction forces: objective measures of gait following hip arthroplasty

McCrory, Jean L.; White, Scott C.; Lifeso, Robert M.

doi:10.1016/s0966-6362(01)00140-0

Cited by 161 publications

(124 citation statements)

References 20 publications

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“…The postoperative patients studied may have continued to guard the replaced joint during ambulation, even at 1 year after surgery. Indeed, previous reports have demonstrated decreased vGRFs and altered temporal loading patterns in patients with postoperative THA compared with subjects' nonoperative hip and the normal controls [28,29]. Lugade et al [19] found that the asymmetric vGRF loading observed before surgery in direct anterior and DL groups persisted at 6 weeks after surgery but was no longer present in either group at 16 weeks.…”

Section: Discussionmentioning

confidence: 96%

Total Hip Arthroplasty Surgical Approach Does Not Alter Postoperative Gait Mechanics One Year After Surgery

Queen

Appleton

Butler

et al. 2013

PM&R

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Objective: To investigate the differences in gait biomechanics on the basis of surgical approach 1 year after surgery. Design: This was a descriptive laboratory study to investigate the side-to-side differences in walking mechanics at a self-selected walking speed as well as a functional assessment 1 year after total hip arthroplasty (THA). Temporospatial, kinetic, and kinematic data as well as functional outcomes were collected. Two-way analysis of variance was used to assess for between-group differences and limb-to-limb asymmetries. Setting: A controlled laboratory study. Participants: This study examined 35 patients with primary, unilateral THA. The THA surgical approaches that were used in these patients included 12 direct lateral, 18 posterior, and 11 anterolateral. All the patients were assessed 1 year after THA. Patients were excluded from the study if they had contralateral hip pain or pathology, or any prior lower extremity total joint replacements. Main Outcome Measurements: Three-dimensional lower extremity kinematics and kinetics as well as spatiotemporal variables were collected. In addition, a series of physical performance measures were collected. Results: No main effects for the physical performance measures or biomechanical variables were observed among the approach groups. Significant limb-to-limb asymmetries were observed among all the patients, with decreased sagittal plane range of motion, peak extension, and peak vertical ground reaction forces on the operative side. Conclusion:The results of this study indicated that no significant differences existed among the different surgical approach groups for any study variable. However, 1 year after THA, the patients demonstrated asymmetric gait patterns regardless of surgical approach, which indicated the potential need for continued intervention through physical therapy to regain normal side-to-side symmetry after THA.

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Section: Discussionmentioning

confidence: 96%

Total Hip Arthroplasty Surgical Approach Does Not Alter Postoperative Gait Mechanics One Year After Surgery

Queen

Appleton

Butler

et al. 2013

PM&R

View full text Add to dashboard Cite

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“…[20][21][22][23] Joint positions linked to high forces or adverse THR outcome include superior or lateral hip joint center, a small abductor moment arm, and a small offset. Theoretically, the main effect of each of these positions is to decrease the moment generating capacity of the abductors, such that they must produce a higher force to generate the same moment, thereby increasing overall implant loads.…”

mentioning

confidence: 99%

Relative importance of gait vs. joint positioning on hip contact forces after total hip replacement

Foucher

Hurwitz

Wimmer

2009

Journal Orthopaedic Research

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Implant loosening is a common indication for total hip replacement (THR) revision. High contact forces and implant twisting moments are thought to be associated with implant loosening. Relationships between joint positioning and hip forces, or outcomes, have been investigated through in vivo and in vitro modalities. Relationships between hip forces and gait are less understood, despite repeated findings that gait following a THR does not fully return to normal. We tested the hypothesis that gait parameters would be better predictors of implant force (peak contact forces and peak twisting moment during walking) than joint positioning parameters. Subjects underwent gait analysis, hip force modeling, and measurement of clinical radiographs 1 year after successful THR surgery. Gait parameters were consistently more influential in determining hip forces. Alone, gait explained as much as 67% of the variation in force, compared to a maximum of 33% by joint geometry. Combinations of gait and joint positioning parameters together explained up to 86% of the variation in hip force parameters. Results suggest that gait may provide a valuable postoperatively modifiable target to improve hip loads and potentially reduce the risk for implant loosening. ß

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“…Several other reports have also demonstrated that some selected measures derived from the vertical ground reaction forces can be used as objective measures in assessing the pathomechanics of gait [15,16]. Asymmetry of the loading rate has been identified as one of them and as the most sensitive indicator of gait dysfunction [8].…”

Section: Discussionmentioning

confidence: 99%

Loading rate patterns in scoliotic children during gait: the impact of the schoolbag carriage and the importance of its position

et al. 2012

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Purpose Concerns have been raised regarding the effects of schoolbag carriage on adolescent schoolchildren and particularly those with a pre-existing spinal deformity. The purpose of this study was to determine the effect of school backpack loads in scoliotic and healthy school-age children during walking, in terms of peak vertical ground reaction forces and loading rates. We hypothesized that walking with a loaded backpack would have a greater effect on gait kinetics of scoliotic compared to healthy. Methods Eight children with idiopathic scoliosis and eight healthy children were assessed. Kinetic data were collected using two AMTI OR6-7 force-plates, while the subjects walked freely along a 6-m walkway under three walking conditions: (1) without a schoolbag, (2) carrying a schoolbag bilaterally (over both shoulders-symmetrical load) and (3) carrying a schoolbag unilaterally (over each shoulder-asymmetrical load). Kinetic data were collected and four parameters were calculated; peak ground reaction force at the first maximum force peak (F1), time needed to reach F1 (T1), loading rate of F1 (LRF1) and total contact time (T2). ResultsWe found no significant differences between the scoliotic and healthy children for any of the kinetic variables examined. In addition, the position of the bag did not seem to have any effect on loading rate. Conclusions The results of this study indicate that in terms of kinetic parameters during normal gait, the schoolbag load (symmetrical or asymmetrical) does not have a different effect on children with mild adolescent idiopathic scoliosis compared to normal controls.

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Vertical ground reaction forces: objective measures of gait following hip arthroplasty

Cited by 161 publications

References 20 publications

Total Hip Arthroplasty Surgical Approach Does Not Alter Postoperative Gait Mechanics One Year After Surgery

Total Hip Arthroplasty Surgical Approach Does Not Alter Postoperative Gait Mechanics One Year After Surgery

Relative importance of gait vs. joint positioning on hip contact forces after total hip replacement

Loading rate patterns in scoliotic children during gait: the impact of the schoolbag carriage and the importance of its position

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