Influence of body mass index on sagittal hip range of motion and gait speed recovery six months after total hip arthroplasty

Martz, Pierre; Bourredjem, Abderrahmane; Maillefert, Jean Francis; Binquet, Christine; Baulot, Emmanuel; Ornetti, Paul; Laroche, Davy

doi:10.1007/s00264-018-4250-y

Cited by 12 publications

(17 citation statements)

References 33 publications

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“…In some of these patients a limited posterior pelvic tilt in sitting position may induce less anterior uncovering of the acetabulum and less posteroinferior coverage which may lead to anterior impingement and posterior dislocation in sitting position [30]. Ultimately, the effect of this postural changes on the gait needs to be studied may not significantly affect the gait pattern clinically similar to other investigations regarding the gait changes after THA [31,32].…”

Section: Discussionmentioning

confidence: 95%

How do global sagittal alignment and posture change after total hip arthroplasty?

Youngwoo

Pour

Lazennec

2019

International Orthopaedics (SICOT)

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Background Postural change after total hip arthroplasty (THA) is still a matter of discussion. Previous studies have mainly concentrated on the pelvic motions. We report the post-operative changes of the global sagittal posture using pelvic, spinal, and lower extremities parameters. Methods 139 patients (primary THA, without previous spinal or lower extremity surgery) were included. We measured pelvic parameters [SS, sacral slope; PI, pelvic incidence; PT, pelvic tilt; APP angle, anterior pelvic plane angle] and the global posture parameters (SVA, sagittal vertical angle; GSA, global sagittal angle; TPA, T1 pelvic angle). Patients were categorized into low PI group < 45°, 45°< medium PI < 65°, and high PI > 65°. Results Mean GSA and SVA decreased post-operatively (p = 0.005 and p = 0.004 respectively). The TPA change was not significant (p = 0.078). In the low PI group, GSA (5.4 ± 5.0 to 4.3 ± 4.0, p = 0.005) and SVA (5.4 ± 4.9 to 4.2 ± 4.1, p = 0.038) decreased with more posterior pelvic tilt. Post-operative TPA was significantly higher (8.4 ± 10.6 to 9.8 ± 10.7; p = 0.048). In the medium PI group, SVA decreased (4.2 ± 4.6 to 3.6 ± 4.5, p = 0.020) with more posterior pelvic tilt. In the high PI group, pelvic and global posture parameters did not evolve significantly. Conclusion PI is the key determining factor in pelvic tilt modification after THA. Patients with low PI demonstrate significant modification in spine, pelvic, and lower extremities. Pelvic tilt is the main adaptation mechanism for medium incidence patients whereas pelvic tilt does not change in high PI patients after surgery.

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Section: Discussionmentioning

confidence: 95%

How do global sagittal alignment and posture change after total hip arthroplasty?

Youngwoo

Pour

Lazennec

2019

International Orthopaedics (SICOT)

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“…In the present study the calculated features were chosen based on the literature [2,3,4,5,6,8,9,10,11,41] and the experience of movement scientists and physical therapists within the research group.…”

Section: Methodsmentioning

confidence: 99%

“…Pietschmann et al [41] showed that the sagittal hip joint angle, measured by means of IMUs, is an essential measure in patients after THA for providing acoustic feedback during treadmill-based gait training. The sagittal hip joint angle was further described as an important measure in patients with THA by several other authors [2,4,5,6,10,11]. Gait speed [4,8,10], maximum hip extension [2,5,6,10], maximum hip flexion [3], pelvis transversal as well as sagittal [2] and frontal [42,43] ROM, stride length [10], stride time and cadence [9] were identified as further measures of interest regarding patients after THA.…”

Section: Methodsmentioning

confidence: 99%

“…However, gait abnormalities, such as asymmetries in the kinematics between implanted and non-implanted hip joints, persist even after successful THA and the consecutive rehabilitation process [2]. The literature reveals persisting changes of the joint angle kinematics of the implanted limb: rather, a higher posterior tilt of the pelvis during stance phase, an increased pelvic drop towards the non-implanted side while loading the implanted side, an increased hip internal rotation and hip adduction as well as a decreased hip extension peak and a reduced hip range of motion (ROM) in the sagittal plane [2,3,4,5,6]. According to Queen et al [6], these asymmetries persist up to one year after the THA and they recommend a continuative physical therapy to eliminate these deviations.…”

Section: Introductionmentioning

confidence: 99%

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Towards an Inertial Sensor-Based Wearable Feedback System for Patients after Total Hip Arthroplasty: Validity and Applicability for Gait Classification with Gait Kinematics-Based Features

Teufl

Taetz

Miezal

et al. 2019

Sensors

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Patients after total hip arthroplasty (THA) suffer from lingering musculoskeletal restrictions. Three-dimensional (3D) gait analysis in combination with machine-learning approaches is used to detect these impairments. In this work, features from the 3D gait kinematics, spatio temporal parameters (Set 1) and joint angles (Set 2), of an inertial sensor (IMU) system are proposed as an input for a support vector machine (SVM) model, to differentiate impaired and non-impaired gait. The features were divided into two subsets. The IMU-based features were validated against an optical motion capture (OMC) system by means of 20 patients after THA and a healthy control group of 24 subjects. Then the SVM model was trained on both subsets. The validation of the IMU system-based kinematic features revealed root mean squared errors in the joint kinematics from 0.24° to 1.25°. The validity of the spatio-temporal gait parameters (STP) revealed a similarly high accuracy. The SVM models based on IMU data showed an accuracy of 87.2% (Set 1) and 97.0% (Set 2). The current work presents valid IMU-based features, employed in an SVM model for the classification of the gait of patients after THA and a healthy control. The study reveals that the features of Set 2 are more significant concerning the classification problem. The present IMU system proves its potential to provide accurate features for the incorporation in a mobile gait-feedback system for patients after THA.

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“…In particular the results show that obese individuals exhibit reduced hip extension, knee flexion and ankle plantarflexion [ 17 , 44 ], which overall lead to a significant reduction of ankle and knee dynamic ROMs. Such alterations, which were reported (individually or in combination) in previous studies on adults and adolescents [ 12 , 45 , 46 , 47 ], might represent, together with reduced walking speed and longer stance phase duration, a strategy to reduce the articular stress and to compensate for the reduced muscular strength and the altered joint proprioception. Walking speed certainly plays a crucial role in defining the sagittal kinematics of gait in obese individuals and can be considered the main cause for the combination of increased knee flexion and increased plantarflexion at toe off [ 12 ].…”

Section: Discussionmentioning

confidence: 73%

Kinematics Adaptation and Inter-Limb Symmetry during Gait in Obese Adults

Capodaglio

Leban

Porta

et al. 2021

Sensors

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The main purpose of this study is to characterize lower limb joint kinematics during gait in obese individuals by analyzing inter-limb symmetry and angular trends of lower limb joints during walking. To this purpose, 26 obese individuals (mean age 28.5 years) and 26 normal-weight age- and sex-matched were tested using 3D gait analysis. Raw kinematic data were processed to derive joint-specific angle trends and angle-angle diagrams (synchronized cyclograms) which were characterized in terms of area, orientation and trend symmetry parameters. The results show that obese individuals exhibit a kinematic pattern which significantly differs from those of normal weight especially in the stance phase. In terms of inter-limb symmetry, higher values were found in obese individuals for all the considered parameters, even though the statistical significance was detected only in the case of trend symmetry index at ankle joint. The described alterations of gait kinematics in the obese individuals and especially the results on gait asymmetry are important, because the cyclic uneven movement repeated for hours daily can involve asymmetrical spine loading and cause lumbar pain and could be dangerous for overweight individuals.

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Influence of body mass index on sagittal hip range of motion and gait speed recovery six months after total hip arthroplasty

Cited by 12 publications

References 33 publications

How do global sagittal alignment and posture change after total hip arthroplasty?

How do global sagittal alignment and posture change after total hip arthroplasty?

Towards an Inertial Sensor-Based Wearable Feedback System for Patients after Total Hip Arthroplasty: Validity and Applicability for Gait Classification with Gait Kinematics-Based Features

Kinematics Adaptation and Inter-Limb Symmetry during Gait in Obese Adults

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