ArticleTreadmill training with partial body-weight support after total hip arthroplasty: a randomized controlled trial1☆,
Section snippets
Participants
Between September 1, 1999, and December 31, 2001, we recruited 812 patients with THA from 1 center, of whom 80 met our inclusion criteria. Inclusion criteria were (1) age under 75 years, (2) first time unilateral total hip replacement for osteoarthrosis or hip fracture, (3) willingness to participate in a 2-week rehabilitation program at Klinik Berlin, (4) fully loadable cemented or cement-free prosthesis, (5) ability to walk reciprocally with 2 forearm aluminum crutches with adjustable forearm
Results
Starting with 40 participants per group, 39 in the treatment group completed the trial and 35 made it to the first follow-up at 3 months. In the control group, 40 completed the trial, 35 made it to follow-up. With further dropouts, 26 patients in the treatment group and 24 in the control group completed the 12-month study (fig 1). The clinical data and the outcome measures did not differ significantly at the beginning of the study for the dropouts from either groups (14 in the treatment group,
Discussion
The treatment group was superior to the control group in every parameter measured, except walking velocity at the end of training and 3 and 12 months later. The patients in the treatment group abandoned their crutches earlier, and none had additional surgery on the same side. In the control group, 4 patients received a reimplant due to loosening within 1 year.
Both groups were homogeneous with respect to the clinical characteristics and the outcome measures before training, the net therapy time
Conclusion
A 10-day TT-BWS program proved superior in hip arthroplasty patients with a fully loadable implant as measured by the Harris score, hip extension deficit, walking symmetry, and hip abductor muscle strength. The repetitive practice of walking in conjunction with a more effective strengthening of the hip abductor may be the factors that explain the better outcome of the treadmill subjects.
Acknowledgements
We thank Manuela Schiesser and Stefanie Grunert for their help with the patients.
References (23)
- et al.
Total hip arthroplasty for arthrosed hips. 5- to 13-year results
J Arthroplasty
(1995) - et al.
Locomotor activity in spinal man
Lancet
(1994) - et al.
Restoration of gait in non-ambulatory hemiparetic patients by treadmill training with partial body weight support
Arch Phys Med Rehabil
(1994) - et al.
Hip joint forces during walking and running, measured in 2 patients
J Biomech
(1993) - et al.
Inhibition of flexor burst generation by loading ankle extensor muscles in walking cats
Brain Res
(1980) National Center for Health Statistics Website
Fast Stats
(2003)Rehabilitation after hip replacementa one-year follow-up
Int J Rehabil Res
(1987)- et al.
[Results of inpatient rehabilitation after total hip replacement]
Rehabilitation (Stuttg)
(1998) - et al.
Laufband locomotion with body weight support in persons with severe spinal cord injuries
Paraplegia
(1992) - et al.
A new approach to retrain gait in stroke patients through body weight support and treadmill stimulation
Stroke
(1998)
Treadmill gait retraining following fractured neck-of-femur
Arch Phys Med Rehabil
Cited by (87)
Unassisted quiet standing and walking after crutch usage in patients with total hip replacements: Does crutch length matter?
2018, Gait and PostureCitation Excerpt :In addition, when comparing groups’ results with normative parameters, EE group stride and step length, and base of support width were closer to what was reported by Hollman et al. [21], for older able-bodied adults than EF group parameters. It seems that EE set-up resulted in a better gait recovery, which is beneficial for patients’ functional recovery [32]. In addition, walking speed has been used for evaluating living independence [33], risk of fall [29,34] and health status [35] in elderly populations.
Gait symmetry measures: A review of current and prospective methods
2018, Biomedical Signal Processing and ControlEffects of a walking training session with a walking-aid robot for patients holding a total knee arthroplasty: Preliminary study
2016, Journal de Readaptation MedicaleAssociation Between Exercise Therapy Dose and Functional Improvements in the Early Postoperative Phase After Hip and Knee Arthroplasty: An Observational Study
2015, PM and RCitation Excerpt :The influence of the exercise dose on changes in function after knee or hip replacement has previously been investigated in only a few studies. These studies showed that high-intensity strength [40,41], water [42], and gait exercise [39] training interventions are feasible and more beneficial for function and strength improvements than low-intensity exercises. Thus we expected that at least the exercise therapy intensity would have had an impact on changes in the WOMAC function score.
Body weight support Tai Chi footwork improves balance function after total hip arthroplasty
2024, Chinese Journal of Tissue Engineering Research
- ☆
Supported by the Bundesversicherungsanstalt für Angestellte, BfA (grant no. 8011-106-31/31.46).
- 1
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.