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短期住院全髋关节置换术后步态的恢复

Recovery of gait after short-stay total hip arthroplasty.

作者信息

van den Akker-Scheek Inge, Stevens Martin, Bulstra Sjoerd K, Groothoff Johan W, van Horn Jim R, Zijlstra Wiebren

机构信息

Department of Orthopedics, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, The Netherlands.

出版信息

Arch Phys Med Rehabil. 2007 Mar;88(3):361-7. doi: 10.1016/j.apmr.2006.11.026.

Abstract

OBJECTIVE

To describe recovery of gait after total hip arthroplasty (THA) based on the assessment of spatiotemporal gait parameters determined with an ambulatory system.

DESIGN

A 6-month inception cohort study.

SETTING

Inpatient and outpatient setting in an academic hospital.

PARTICIPANTS

Sixty-three patients participating in a short-stay program for THA.

INTERVENTION

Primary unilateral THA.

MAIN OUTCOME MEASURES

Walking speed, step length, step duration, and variability coefficient assessed at different walking speeds while performing an additional cognitive task and an endurance test. All measures were obtained preoperatively and 6 weeks and 6 months postoperatively.

RESULTS

Patients improved significantly over time; however, extent and speed of recovery of gait parameters differed for each test part. The relation between walking speed and step length showed systematic improvement when analyzed over a range of speeds. At 6 months, the variability coefficient of the additional task test part was comparable with the preferred walking variability coefficient. The endurance test results could be predicted from the results of preferred walking.

CONCLUSIONS

Assessment of recovery of gait function requires more than only assessment of "normal" walking. Particularly, an analysis of walking at different speeds and walking while performing an additional cognitive task demonstrate different aspects of gait recovery after THA.

摘要

目的

基于对使用动态系统测定的时空步态参数的评估,描述全髋关节置换术(THA)后步态的恢复情况。

设计

一项为期6个月的队列起始研究。

地点

一所学术医院的住院和门诊环境。

参与者

63名参与THA短期项目的患者。

干预措施

初次单侧THA。

主要观察指标

在执行额外认知任务和耐力测试时,于不同步行速度下评估步行速度、步长、步幅持续时间和变异系数。所有测量均在术前以及术后6周和6个月时进行。

结果

患者随时间显著改善;然而,每个测试部分的步态参数恢复程度和速度有所不同。当在一系列速度范围内进行分析时,步行速度与步长之间的关系显示出系统性改善。在6个月时,额外任务测试部分的变异系数与首选步行变异系数相当。耐力测试结果可根据首选步行结果进行预测。

结论

对步态功能恢复的评估需要的不仅仅是对“正常”步行的评估。特别是,对不同速度下的步行以及在执行额外认知任务时的步行进行分析,可展示THA后步态恢复的不同方面。

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