Is early weight bearing resumption beneficial after total hip replacement?
| Autor: | J. Merle, D. Lamotte, Patrice Rougier, S. Cantalloube, D. Belaid |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Arthroplasty Replacement Hip medicine.medical_treatment medicine.disease_cause Rehabilitation Centers Risk Assessment Osteoarthritis Hip Body Mass Index Weight-bearing Cohort Studies Weight-Bearing Reference Values Postural Balance Humans Medicine Orthopedics and Sports Medicine Force platform Range of Motion Articular Aged Pain Measurement Probability Balance (ability) Aged 80 and over Postoperative Care Hip surgery Rehabilitation Anthropometry business.industry Total hip replacement Recovery of Function Middle Aged Arthroplasty Surgery Treatment Outcome Physical therapy Female Hip Prosthesis Stress Mechanical Range of motion business Follow-Up Studies |
| Zdroj: | Orthopaedics & Traumatology: Surgery & Research. 95:127-133 |
| ISSN: | 1877-0568 |
| DOI: | 10.1016/j.otsr.2008.12.001 |
| Popis: | Summary Objective Current rehabilitation protocols of patients following total hip replacement recommend weight bearing on the operated extremity as early as possible. This strategy is likely to induce specific consequences on postural balance control; this study seeks to highlight these reactions to early loading. Materials and methods Eight men and six women, ranging in age from 57 to 85 years, volunteered enrolling this study on their arrival at our rehabilitation center. This study assessed their postural behavior using a system composed of two separate force platforms under two loading situations; in the course of these tests they were required to minimize their body sway as much as possible by keeping their eyes open. In the natural uncontrolled situation, the subjects adopted a comfortable body weight distribution. In the imposed (IMP) situation, they had to load their operated extremity more than in regular natural conditions in order to distribute their body weight more evenly. Three successive 32-s trials (sampled at 64 Hz) with intermediate recovery periods of equivalent duration were performed allowing period of rest between each trial. The balance strategies were evaluated through a frequency analysis of the resultant and plantar centers of pressure (CP Res ) of each foot and of the estimated trajectories of the vertical projection of the center of gravity (CG), and from the difference CP Res –CG. Results No difference was found for the plantar CP trajectories in the situation where body weight is spontaneously distributed, whereas loading the implanted extremity induced increased CP Res , CG, and CP Res –CG trajectory amplitudes along the mediolateral axis. No effect was observed along the anteroposterior axis. Finally, when comparing the two limbs for each testing condition, the statistical analysis demonstrated greater displacements along the ML axis for the trajectories measured under the healthy leg than under the implanted extremity. Discussion Loading the operated extremity early in the rehabilitation process leads to less stability (an increase in the CG movements) and to increased energy expenditure (an increase in the CP Res –CG movements). These postural behavior alterations can be explained by various factors including a loss of muscle strength, residual apprehension due to the disuse of this limb, and persistent pain, all of which are increased by limb loading. These features should be taken into consideration when elaborating the rehabilitation protocol for these patients. Level of evidence: Level III. Decision analyses study. |
| Databáze: | OpenAIRE |
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