Mobile Robot-Based Gait Training after Total Hip Arthroplasty (THA) Improves Walking in Biomechanical Gait Analysis

Abstract

There are multiple attempts to decrease costs in the healthcare system while maintaining a high treatment quality. Digital therapies receive increasing attention in clinical practice, mainly relating to home-based exercises supported by mobile devices, eventually in combination with wearable sensors. The aim of this study was to determine if patients following total hip arthroplasty (THA) could benefit from gait training on crutches conducted by a mobile robot in a clinical setting. Method: This clinical trial was conducted with 30 patients following total hip arthroplasty. Fifteen patients received the conventional physiotherapy program in the clinic (including 5 min of gait training supported by a physiotherapist). The intervention group of 15 patients passed the same standard physiotherapy program, but the 5-min gait training supported by a physiotherapist was replaced by 2 × 5 min of gait training conducted by the robot. Length of stay of the patients was set to five days. Biomechanical gait parameters of the patients were assessed pre-surgery and upon patient discharge. Results: While before surgery no significant difference in gait parameters was existent, patients from the intervention group showed a significant higher absolute walking speed (0.83 vs. 0.65 m/s, p = 0.029), higher relative walking speed (0.2 vs. 0.16 m/s, p = 0.043) or shorter relative cycle time (3.35 vs. 3.68 s, p = 0.041) than the patients from the control group. Conclusion: The significant higher walking speed of patients indicates that such robot-based gait training on crutches may shorten length of stay (LOS) in acute clinics. However, the number of patients involved was rather small, thus calling for further studies.

Robot-Assisted Gait Self-Training: Assessing the Level Achieved

“…This could in turn lead to a faster recovery. This hypothesis was supported by the initial results of the small-scale clinical efficacy study, which showed a significant improvement in the hip and knee joint flexibility of the patients [ 4 ].…”

“…The results of the efficacy study are summarized from a medical point of view in [ 4 ]. Based on literature studies, it was shown in [ 4 ] that patients after hip prosthesis surgery walk more slowly and have a lower hip range of motion than healthy individuals. In addition, ref.…”

“…In addition, ref. [ 4 ] discussed the importance of corrective gait training after hip arthroplasty surgery as an important aspect of fall prevention, as it corrects pain avoidance strategies acquired before surgery that may lead to falls.…”

“…The similar results in the clinical scores of both groups were also positive, as patients in the group with additional training did not have higher subjectively perceived pain despite the increased movement. The details of the results achieved from a medical point of view together with details to statistically significant improvement of gait parameters were shown in [ 4 ].…”

“…This paper is based on [ 2 , 3 , 4 ], which contain concrete details to the results obtained from SAR-assisted gait training and supplements these with considerations of the above issues.…”