Efficacy of Combined Antigravity Treadmill and Conventional Rehabilitation After Hip Fracture in Patients With Sarcopenia

Abstract

Background To compare long-term effects of antigravity treadmill (AGT) combined with conventional rehabilitation (CR) and CR after hip fracture in patients with sarcopenia. Methods Forty-five patients were randomly allocated to AGT combined with CR (experimental group) or CR (control group) for 10 consecutive working days. Participants were evaluated prior to treatment, 3 weeks, 3 months, and 6 months after treatment. Outcome measurement included Koval walking ability scores functional ambulatory category (FAC), Berg Balance Scale (BBS), Korean version of Mini-Mental State Examination, Euro Quality of Life Questionnaire Five-Dimensional Classification, Korean version of modified Barthel index, and grip strength. Results At 3 weeks and 3 months, the comparison of change scores in KOVAL between two groups revealed difference of 0.84 (95% CI: −1.19, −0.49; p for trend = .000) and 1.21 (95% CI: −2.05, −0.36; p for trend = .006), respectively. At 3 weeks, comparison of change score in FAC between two groups revealed a difference of 0.73 (95% CI: 0.28, 1.19; p for trend = .003). The comparison of change scores between two groups also showed a difference in the 6 months in KOVAL and in the 3 and 6 months in FAC. The comparison of changes in scores in BBS between two groups revealed difference of 11.63 (95% CI: 5.85, 17.40; p for trend = .001), 9.00 (95% CI: 2.28, 15.71; p for trend = .006), and 11.05 (95% CI: 3.62, 18.48; p for trend = .006), respectively, at each follow-up. Conclusions Both groups were improved after intervention. As additional benefits were evident among those who carried out AGT, it may be appropriate for patients with sarcopenia after hip fracture surgery.

Rehabilitation Strategies for Patients with Femoral Neck Fractures in Sarcopenia: A Narrative Review

“…Various definitions of sarcopenia have been developed by different international consensus panels, (the Asian Working Group on Sarcopenia (AWGS), the European Working Group on Sarcopenia in Older People (EWGSOP) and the Foundation of the National Institute of Health, International Working Group on Sarcopenia) each defining cut-off values from mobility limitation measures (appendicular skeletal mass index, grip strength and physical performance). In our review, the authors specifically used the diagnostic criteria included in the AWGS [ 21 , 22 , 23 , 24 , 25 ] and EWGSOP [ 1 , 16 , 19 , 20 ].…”

“…Study 3 [ 23 ] compared the efficacy of an antigravity treadmill (AGT) combined with conventional physical therapy, and physical therapy alone, in a double-blinded (to outcome) study. Selected patients were 65–90 years old, who had undergone surgery for FNF associated with sarcopenia, according to the AWGS recommendation [ 25 ].…”

“…To strengthen muscle and physical function, progressive resistance exercise training is a commonly used tool [ 21 , 22 , 23 ]. Ambulatory independence is a crucial outcome to examine in patients after hip-surgery, and it must be evaluated before and after the surgery intervention and rehabilitation protocol.…”

“…Type and intensity of exercise is an important variable that significantly influences functional outcomes in FNF patients. Study 3 [ 23 ], compared the effects of antigravity treadmill rehabilitation with conventional rehabilitation and conventional rehabilitation alone, and which did not include progressive resistance training and was uncertain in terms of compliance, found an important and significant improvement in the ability to walk, ambulatory function, general mobility, balance and quality of life in the experimental group. The antigravity treadmill, in fact, allowed a task-specific repetitive approach, facilitating the practice of numerous complex gait cycles, which were not possible in the control group.…”

Effect of 4 Weeks of Anti-Gravity Treadmill Training on Isokinetic Muscle Strength and Muscle Activity in Adults Patients with a Femoral Fracture: A Randomized Controlled Trial

“…Moreover, previous studies have reported that muscle strength exercise and aerobic exercise using an anti-gravity treadmill resulted in improved walking and dynamic balance, while maintaining the same kinetic movement as normal walking and reducing the amount of pressure on the musculoskeletal system [13,15,16]. Thus, anti-gravity treadmill training is an intervention for preventing quadriceps muscle atrophy and for muscle strengthening in patients with femoral fractures [17,18]. Further, it enables partial weight bearing at the initial stage, which may help provide stability for normal gait in the future.…”