Scott C White1, Robert M Lifeso. 1. Department of Exercise and Nutrition Sciences, State University of New York, Buffalo, NY 14214-3079, USA. swhite@acsu.buffalo.edu
Abstract
OBJECTIVE: To evaluate a walking program incorporating real-time biofeedback to reduce asymmetric limb loading after total hip arthroplasty (THA). DESIGN: Within-subject clinical intervention. SETTING: Biomechanics laboratory. PARTICIPANTS: Volunteers were screened for confounding disorders that could affect their gait other than unilateral THA. Participants included 28 subjects who were evaluated a minimum of 2 months after surgery and ambulatory without assistive devices. INTERVENTIONS:THA subjects were assigned to a feedback, no-feedback, or control group. The feedback group walked on a treadmill 15 minutes, 3 times a week for 8 weeks while matching step-to-step reaction forces. Subjects walking without feedback had equal time. The control group did not train. MAIN OUTCOME MEASURES: Symmetry indices for peak limb-loading force, rate of rise of loading force, and impulse calculated from vertical foot-ground forces. Symmetry index changes were evaluated using 2-factor, repeated-measures analyses of variance with a Tukey post hoc test. RESULTS:Loading rate and impulse equalization improved for the feedback group (P<.01). Loading rate equalization improved for the no-feedback group (P=.01). There were no changes for the control group. CONCLUSIONS: This preliminary study suggests that a treadmill walking program may help persons with a THA achieve a more symmetric gait. Additional investigation of the potential benefits of a rehabilitation program incorporating treadmill walking with and without biofeedback is recommended.
RCT Entities:
OBJECTIVE: To evaluate a walking program incorporating real-time biofeedback to reduce asymmetric limb loading after total hip arthroplasty (THA). DESIGN: Within-subject clinical intervention. SETTING: Biomechanics laboratory. PARTICIPANTS: Volunteers were screened for confounding disorders that could affect their gait other than unilateral THA. Participants included 28 subjects who were evaluated a minimum of 2 months after surgery and ambulatory without assistive devices. INTERVENTIONS: THA subjects were assigned to a feedback, no-feedback, or control group. The feedback group walked on a treadmill 15 minutes, 3 times a week for 8 weeks while matching step-to-step reaction forces. Subjects walking without feedback had equal time. The control group did not train. MAIN OUTCOME MEASURES: Symmetry indices for peak limb-loading force, rate of rise of loading force, and impulse calculated from vertical foot-ground forces. Symmetry index changes were evaluated using 2-factor, repeated-measures analyses of variance with a Tukey post hoc test. RESULTS: Loading rate and impulse equalization improved for the feedback group (P<.01). Loading rate equalization improved for the no-feedback group (P=.01). There were no changes for the control group. CONCLUSIONS: This preliminary study suggests that a treadmill walking program may help persons with a THA achieve a more symmetric gait. Additional investigation of the potential benefits of a rehabilitation program incorporating treadmill walking with and without biofeedback is recommended.
Authors: Cory L Christiansen; Michael J Bade; Roger J Paxton; Jennifer E Stevens-Lapsley Journal: Clin Biomech (Bristol, Avon) Date: 2015-05-09 Impact factor: 2.063
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