The Importance of Cognitive Executive Functions in Gait Recovery After Total Hip Arthroplasty

Negrini, Francesco; Preti, Matteo; Zirone, Eleonora; Mazziotti, Daniele; Biffi, Marco; Pelosi, Catia; Banfi, Giuseppe; Zapparoli, Laura

doi:10.1016/j.apmr.2019.12.004

Cited by 10 publications

(18 citation statements)

References 25 publications

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“…Cognitive and psychological data were collected via tabletsupported video calls with a neuropsychologist, with the aid of a clinician who was physically with the patient. We performed Mini-Mental State Examination (MMSE), 5 which is a general cognitive assessment, and the Frontal Assessment Battery, 6,7 which is a global evaluation of executive functions. Moreover, we collected measures of mood and anxiety traits using the State-Trait Anxiety Inventory 8 and the Beck Depression Inventory.…”

Section: Cognitive Evaluationmentioning

confidence: 99%

Neuropsychological Features of Severe Hospitalized Coronavirus Disease 2019 Patients at Clinical Stability and Clues for Postacute Rehabilitation

Negrini

Ferrario

Mazziotti

et al. 2021

Archives of Physical Medicine and Rehabilitation

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103

106

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Objective To report the cognitive features of severe COVID-19 patients entering in the post-acute phase, to understand whether COVID-19 acute respiratory distress syndrome itself could result in long-term cognitive deficits and whether neuropsychological treatment after the acute stage might represent a specific rehabilitation need. Design Case series. Setting Rehabilitation hospital. Participants We assessed the general cognitive functioning, through tablet-supported video-call, in 9 of 12 consecutive patients admitted to the hospital at least 30 days earlier for acute respiratory distress syndrome due to COVID-19. None of these patients presented cognitive symptoms before the hospitalization. Main Outcome Measures General Cognitive functioning, measured using the Mini-Mental State Examination Test. Results A general cognitive decay was observed in three patients (33.3%), who had a pathological score at the Mini-Mental State Examination (MMSE), with a specific decline in attention, memory, language and praxis abilities. The cognitive (mal)functioning seems to be linearly associated with the length of stay (in days) in the intensive care unit (ICU): the higher the number of days spent in the ICU, the lower the MMSE score (indicating a lower global cognitive functioning). Conclusions Our results indicate that some COVID-19 patients might also benefit from a neuropsychological rehabilitation, given their possible global cognitive decay. The link between the neuropsychological functioning and the length of stay in the ICU suggests that neurocognitive rehabilitative treatments should be directed explicitly towards patients who are treated in the ICU care, rather than towards every patient who suffered from acute respiratory distress syndrome due to COVID-19. However, given the limitation of a case series study, those hypotheses should be tested with future studies with larger samples and a longer follow-up.

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Section: Cognitive Evaluationmentioning

confidence: 99%

Neuropsychological Features of Severe Hospitalized Coronavirus Disease 2019 Patients at Clinical Stability and Clues for Postacute Rehabilitation

Negrini

Ferrario

Mazziotti

et al. 2021

Archives of Physical Medicine and Rehabilitation

Self Cite

103

106

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“…Exercises were focused on recovering optimal passive and active knee range of motion, strength and neuromuscular control of the lower limb, while regaining full autonomy in postural changes, ambulation with two crutches and in activities of daily living. For more details, see Negrini et al 28 .…”

Section: Study Design and Measures Collectedmentioning

confidence: 99%

Motor imagery training speeds up gait recovery and decreases the risk of falls in patients submitted to total knee arthroplasty

Zapparoli

Sacheli

Seghezzi

et al. 2020

Sci Rep

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With Motor imagery (MI), movements are mentally rehearsed without overt actions; this procedure has been adopted in motor rehabilitation, primarily in brain-damaged patients. Here we rather tested the clinical potentials of MI in purely orthopaedic patients who, by definition, should maximally benefit of mental exercises because of their intact brain. To this end we studied the recovery of gait after total knee arthroplasty and evaluated whether MI combined with physiotherapy could speed up the recovery of gait and even limit the occurrence of future falls. We studied 48 patients at the beginning and by the end of the post-surgery residential rehabilitation program: half of them completed a specific MI training supported by computerized visual stimulation (experimental group); the other half performed a nonmotoric cognitive training (control group). All patients also had standard physiotherapy. By the end of the rehabilitation, the experimental group showed a better recovery of gait and active knee flexionextension movements, and less pain. The number of falls or near falls after surgery was significantly lower in the experimental group. These results show that MI can improve gait abilities and limit future falls in orthopaedic patients, without collateral risks and with limited costs.

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“…Muscle strength alone does not reflect overall post-surgical functional outcome with its relative importance debated [37,[99][100][101][102] . However, muscle strength is an important post-surgical outcome that forms the basis of musculoskeletal rehabilitation and may inform the direction of the exercise program aimed at optimizing functional recovery following THA [64][65][66][67][68][69] .…”

Section: Discussionmentioning

confidence: 99%

“…While abductor mechanism dysfunction has most commonly been attributed to the direct incision or detachment of muscles in the lateral approach, other reasons like blunt trauma, retraction, denervation injury, and less common factors like thermal injury from polymethyl methacrylate can lead to damage to other muscles around the hip, including during modified or minimally invasive approaches 109,[115][116][117] . Despite this, our systematic review found a poor representation of muscle groups other than hip abductors in the comparative studies assessing strength changes following THA approaches 69,[71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][96][97][98][99][100][101][102][103][104][105][106][107][108][109] . It shows that despite persisting strength and functional abnormalities being reported following THA, not enough muscle strength data was found to compare different approaches or establish the superiority of one approach.…”

Section: Discussionmentioning

confidence: 99%

Muscle strength changes following different surgical approaches used in primary total hip arthroplasty: A Systematic Review and Meta-analysis

Varma¹,

Ganderton²,

El-Ansary³

et al. 2022

J Orthop Rehabil Res

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Background: Persistent functional abnormalities and strength deficits are commonly reported despite the advances in surgical approaches for primary total hip arthroplasty (THA). Understanding the influence of different approaches on hip muscle strength changes following THA may play a crucial role in optimizing post-operative recovery. Aim: Systematic review and meta-analysis of between-approach comparison of directly measured hip muscle strength following primaryTHA. Method: A comprehensive online database search was performed, identifying studies that compare muscle strength between at least two different THA approaches. Based on Cochrane guidelines, a qualitative and quantitative analysis was completed along with a meta-analysis of the eligible studies. ROBINS-i and ROB-2 were used to analyse the risk of bias, and the Pedro tool was used for quality appraisal. Results: 881 publications were appraised, yielding 23 eligible publications. Sufficient data for analysis was found only between posterior and lateral approaches for hip abduction strength in all categories. No statistically significant difference was found between the two approaches at 12 months and over time-period following THA (Z=1.51, P=0.13, Std Mean diff = 0.24, 95% CI [-.07,.56]). However, the results slightly favoured posterior approach. Additionally, no statistically significant difference found in the strength ratio of the operated side to the unoperated side (U = 15, z = -0.52, p = 0.69) or in the percentage change in muscle strength at 3 months (U=10, z=-.577, p=0.686) and 12 months (U = 10, z=-.577, p = 0.686) from pre-operative baseline. Conclusion: This systematic review and meta-analysis found no statistically significant difference between posterior and lateral approaches for directly measured hip muscle strength measured. Despite the increasing popularity of AA, ALA, and other minimally invasive or modified approaches, and the relationship between muscle strength and function, a sparsity was identified in published studies that performed a comparison between approaches of hip muscle strength.

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The Importance of Cognitive Executive Functions in Gait Recovery After Total Hip Arthroplasty

Cited by 10 publications

References 25 publications

Neuropsychological Features of Severe Hospitalized Coronavirus Disease 2019 Patients at Clinical Stability and Clues for Postacute Rehabilitation

Neuropsychological Features of Severe Hospitalized Coronavirus Disease 2019 Patients at Clinical Stability and Clues for Postacute Rehabilitation

Motor imagery training speeds up gait recovery and decreases the risk of falls in patients submitted to total knee arthroplasty

Muscle strength changes following different surgical approaches used in primary total hip arthroplasty: A Systematic Review and Meta-analysis

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