Gait symmetry and hip strength in women with developmental dysplasia following hip arthroplasty compared to healthy subjects: A cross-sectional study

Abstract

IntroductionUntreated unilateral developmental dysplasia of the hip (DDH) results in asymmetry of gait and hip strength and may lead to early osteoarthritis, which is commonly treated with a total hip arthroplasty (THA). There is limited knowledge about the obtained symmetry of gait and hip strength after the THA. The objectives of this cross-sectional study were to: a) identify asymmetries between the operated and non-operated side in kinematics, kinetics and hip strength, b) analyze if increased walking speed changed the level of asymmetry in patients c) compare these results with those of healthy subjects.MethodsWomen (18–70 year) with unilateral DDH who had undergone unilateral THA were eligible for inclusion. Vicon gait analysis system was used to collect frontal and sagittal plane kinematic and kinetic parameters of the hip joint, pelvis and trunk during walking at comfortable walking speed and increased walking speed. Furthermore, hip abductor and extensor muscle strength was measured.ResultsSix patients and eight healthy subjects were included. In the patients, modest asymmetries in lower limb kinematics and kinetics were present during gait, but trunk lateral flexion asymmetry was evident. Patients’ trunk lateral flexion also differed compared to healthy subjects. Walking speed did not significantly influence the level of asymmetry. The hip abduction strength asymmetry of 23% was not statistically significant, but the muscle strength of both sides were significantly weaker than those of healthy subjects.ConclusionsIn patients with a DDH treated with an IBG THA modest asymmetries in gait kinematics and kinetics were present, with the exception of a substantial asymmetry of the trunk lateral flexion. Increased walking speed did not result in increased asymmetries in gait kinematics and kinetics. Hip muscle strength was symmetrical in patients, but significantly weaker than in healthy subjects. Trunk kinematics should be included as an outcome measure to assess the biomechanical benefits of the THA surgery after DDH.

Towards Inertial Sensor Based Mobile Gait Analysis: Event-Detection and Spatio-Temporal Parameters

“…Few systems can cover a wide range of parameters. For the measurement of 3D JK and STP it is common to use a marker based optical motion capture (OMC) system in combination with force or pressure plates [6,7]. However, OMC systems tend to be expensive, laboratory-bound and their usage tends to be time consuming and needs expert knowledge.…”

Increased Muscle Strength Limits Postural Sway During Daily Living Activities in Total Hip Arthroplasty Patients

“…31 It has been demonstrated that gait asymmetry increases with increased speed. 21 In contrast, Leijendekkers et al 20 found that increased walking speed in THA patients did not result in increased asymmetries in gait kinematics and kinetics. Their findings might be explained by the findings from Lee et al 32 who demonstrated that a larger sway is associated with increased gait velocity in those with a clinical normal gait but not in those with abnormal gait pattern, and that the relationship between trunk sway and gait velocity differs depending on whether gait is clinically normal.…”

“…However, others have found that THA patients are significantly weaker and have differences regarding gait symmetry compared with healthy subjects. 20,28 Rapp et al 28 found that THA patients had improved gait symmetry after an intensive rehabilitation program, but they were still impaired 1 mo postoperatively compared with healthy control subjects. It is reasonable to anticipate that just 1 mo of rehabilitation, as demonstrated in the study by Rapp et al 28 was too short a time to restore muscle strength and gait symmetry.…”

“…In combination with reduced muscular strength, postural imbalance might therefore be expected. 18,19 Leijendekkers et al 20 found that muscle strength was significantly reduced after THA compared with muscle strength in healthy subjects and that postoperative trunk lateral flexion asymmetry during gait was evident and differed compared with healthy subjects.…”

Post-operative Physical Performance Factors Associated With Gait Speed in Patients Surgically Treated for Hip Fracture: A Cross-Sectional Study

“…Isometric strength of the hip abductors was associated with post-operative gait speed. Leijendekkers et al [34] found that hip abduction strength on the operated side was on average 23% lower than that on the non-operated side, and Kubota et al [35] demonstrated that hip abductor muscle strength was significantly correlated with the peak hip abduction moment; indeed, a reduced hip abduction moment after hip fracture may result in an abnormal hip motion, which could slow gait speed. Kline et al [24] found that the strength of the hip extensors and hip abductors on the operated side predicted gait speed after hip fracture.…”