Changes of and interrelationships between performance-based function and gait and patient-reported function 1 year after total hip arthroplasty (original) (raw)
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Physical Functioning Before and After Total Hip Arthroplasty: Perception and Performance
Physical Therapy, 2008
Background and Purpose Self-report and performance-based measures of physical functioning in people before and after total hip arthroplasty seem to present different information. The relationship between these different measures is not well understood, and little information is available about changes in this relationship over time. The aims of this study were: (1) to determine the relationship between self-report and performance-based measures of physical functioning before and after total hip arthroplasty, (2) to assess the influence of pain on the relationship, and (3) to determine whether the relationship changes over time. Subjects and Methods Seventy-five subjects admitted for total hip arthroplasty were included and examined before and 6 and 26 weeks after surgery. The relationships between the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical functioning subscale and walking speed and gait variability were examined by use of generalized estimati...
Journal of Orthopaedic Research, 2021
Summarizing results of three-dimensional (3D) gait analysis into a comprehensive measure of overall gait function is valuable to discern to what extent gait function is affected, and later recovered after surgery and rehabilitation. This study aimed to investigate whether preoperative gait function, quantified and summarized using the Cardiff Classifier, can predict improvements in postoperative patient-reported activities of daily living, and overall gait function 1 year after total hip arthroplasty (THA). Secondly, to explore relationships between pre-to-post surgical change in gait function versus changes in patient-reported and performance-based function. Thirty-two patients scheduled for THA and 25 nonpathological individuals were included in this prospective cohort study. Patients were evaluated before THA and 1 year postoperatively using 3D gait analysis, patient-reported outcomes, and performance-based tests. Kinematic and kinetic gait parameters, derived from 3D gait analysis, were quantified using the Cardiff Classifier. Linear regressions investigated the predictive value of preoperative gait function on postoperative outcomes of function, and univariate correlations explored relationships between pre-to-post surgical changes in outcome measures. Preoperative gait function, by means of Cardiff Classifier, explained 35% and 30% of the total variance in change in patient-reported activities of daily living, and in gait function, respectively. Moderate-to-strong correlations were found between change in gait function and change in patient-reported function and pain, while no correlations were found between change in gait function and performance-based function. Clinical significance: Preoperative gait function predicts postsurgical function to a moderate degree, while improvements in gait function after surgery are more closely related to how patients perceive function than their maximal performance of functional tests.
Gait Parameters and Muscle Activation Patterns at 3, 6 and 12 Months After Total Hip Arthroplasty
The Journal of Arthroplasty, 2014
Gait analysis was performed on 20 patients with unilateral hip prosthesis (3, 6 and 12 months postoperatively) and 20 controls to investigate their gait characteristics and muscle activation patterns. One year after the intervention, patients still walked with a higher percentage of "atypical" cycles, a prolonged heel contact, a shortened flat foot contact, a reduced hip dynamic range of motion and abnormal timing in the muscle activation patterns of tibialis anterior, gastrocnemius lateralis, biceps femoris and gluteus medius, with respect to the control group. Although the gait velocity and the knee range of motion improved from 3 to 6 months post-surgery, the above mentioned parameters did not improve from 6 to 12 months. THA patients failed to obtain normal gait one year after surgery.
Changes in gait patterns and muscle activity following total hip arthroplasty: A six-month follow-up
Clinical Biomechanics, 2013
Background: Appropriate gait function is an important determinant of the outcome of total hip arthroplasty and relies on appropriate joint motion and muscle activity. The purpose of this study was to test the hypothesis that 6-month postoperative dynamic joint range of motion, time-distance measures and muscle activity in the operated limb in patients undergoing total hip arthroplasty differ from preoperative levels and are more similar to those observed postoperatively in the contralateral limb and in healthy subjects. Methods: Basic time-distance gait measurements, knee and hip kinematics and electromyographic activity from eight hip muscles were obtained preoperatively and 6 months postoperatively in 52 patients undergoing total hip arthroplasty and in 24 age-matched healthy subjects during treadmill walking. Findings: Postoperative dynamic hip range of motion for the operated limb (confidence interval differences [− 3.9°; − 2.3°]) and postoperative knee range of motion for both limbs (operated: [− 8.4°; − 5.6°]; contralateral: [− 8.1°; − 5.3°]) in patients with total hip arthroplasty were significantly lower than values for the control subjects (P b 0.001). Postoperative gait in patients with total hip arthroplasty was more symmetric than preoperative gait. Preoperative and postoperative electromyographic intensities were higher in patients with total hip arthroplasty than values for the control subjects (P b 0.001), and patients had different EMG patterns compared to the control group. Interpretation: Pre-and postoperative differences not only in hip but also in knee kinematics emphasize the importance of evaluating the dynamic outcome of total hip arthroplasty by assessing joint motion of all lower extremity joints in both legs.
HIP International, 2018
Introduction:Total hip arthroplasty (THA) is a successful procedure for relieving symptoms of severe osteoarthritis. Surgical approach is a key factor in early recovery and although controversial, little has been written about the direct anterior (DA) approach using objective early measures.Methods:78 participants were prospectively enrolled to undergo a THA through either a DA or direct lateral (DL) surgical approach. Outcome measures were collected preoperatively and at discharge from the hospital, and 2-, 6- and 12-weeks. Outcome measures included the GAITRite®system to measure gait velocity, stride length, single-limb support and single-limb support symmetry. At each time point participants also completed the Timed Up and Go (TUG), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), 12-Item Short-Form Survey (SF-12), Harris Hip Score, and pain visual analog scale (VAS).Results:We found statistically significant differences in gait velocity at discharge, 2...
The Journal of Arthroplasty, 2013
Multiple surgical approaches exist for total hip arthroplasty (THA). Each approach has risks and benefits in regard to complications and changes in postoperative gait. This study examined the effect of three surgical approaches on postoperative gait mechanics. Thirty patients completed a self-selected speed level walking gait assessment preoperatively, 6 weeks, and 1 year after surgery. We found no difference between approaches 1 year following surgery for any study variable. Several differences existed between time points independent of surgical approach. Significant improvement was found in sagittal and frontal plane hip ROM, peak hip extension and adduction angle and moment, the functional measures, walking speed, and the Harris Hip Score. This study suggests that postoperative gait changes are similar for the three analyzed surgical approaches.
European Journal of Orthopaedic Surgery and Traumatology, 2002
This study aimed at finding a relationship between functional results obtained after a total hip arthroplasty and gait analysis. One hundred primary Charnley prosthesis (66 patients) were reviewed, with a mean follow-up of 4.5 (1-22) years with good or very good functional results according to the MDA scale. Hip kinematic parameters were studied with the VICON system, and results were compared with those of a control group of 55 subjects matched for sex, age and height. Cadence did not seem to be related to functional results. Speed, step length and hip flexion-extension amplitude were related to the functional score. Patients with the best functional results appeared to be close to the control group for these criteria. A relationship was also observed between rotation amplitude and functional results but was greater in patients with the best results than in control subjects. Because of these relationships between functional results and kinematic parameters, kinematic studies could be useful for objective comparisons between the results of various surgical techniques. Such comparisons would be more objective than those based on functional scores, including subjective items. It remains to be demonstrated whether the measure of these kinematic parameters would provide greater sensitivity than the simple use of a functional scale.
The assessment of short-term functional outcomes after total hip arthroplasty: An original research
International journal of health sciences
Introduction–Total hip replacement (THR) is highly effective procedure for patients with hip joint deterioration by various conditions, as it relieves pain, improve mobility, attain stability with restoration of limb length and normal mechanics of hip joint, thus improving the standard of life for patient. Objective- The objectives of the study are: 1. To assess the short-term functional outcome in patients undergoing total hip arthroplasty post operatively. 2.Comparison of Harris hip score of present study with available literature. Material and methods- A total 40 patients with 53 hips with whom Total hip replacement was done, were followed up in this prospective observational study, on the basis of pre-defined inclusion and exclusion criteria. ANNOVA test and paired t test was done for statistical analysis. Significance level was fixed at P < 0.05. Result- In our study post op average HHS pain score increased to 37.95, thus improving patients gait and daily activities score to...
Changes in gait symmetry, gait velocity and self-reported function following total hip replacement
Journal of Rehabilitation Medicine, 2011
To investigate the magnitude of change at different time points in measures of gait symmetry, gait velocity and self-reported function following total hip replacement. Design: Longitudinal with test occasions pre-surgery and 3, 6 and 12 months post-surgery. Subjects: Thirty-four patients with hip osteoarthritis (mean age 63 years, standard deviation 11 years). Methods: Subjects walked back and forth along a 7-m walkway at slow, preferred and fast speed. Anteroposterior, vertical and mediolateral trunk symmetry was assessed by accelerometry, while single support symmetry, step-length symmetry and gait velocity was simultaneously assessed by an electronic walkway. Self-reported function was assessed by Hip disability and Osteoarthritis Outcome Score. Gait symmetry data were normalized for gait velocity. Changes between test occasions were reported as effect size. Results: All measures showed effect sizes > 0.30 from preoperative to 12-months postoperative assessments, and improvements were significant (p < 0.05) in all measures, except medio lateral symmetry. In general, gait symmetry and gait velocity improved most 6 and 12 months postoperatively, while self-reported function improved most 3 months postoperatively. Conclusion: Early improvements were seen in self-reported function, suggesting immediate relief from stiffness and pain, while gait symmetry and velocity improved later postoperatively, suggesting that gait quality and performance require prolonged rehabilitation with postoperative guidance, muscular strengthening and motor relearning.