From the Anshin Hospital, Chuo-ku, Kobe City, Hyogo, Japan (OW, SN, KM); Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Nishi-ku, Kobe, Hyogo, Japan (TA); and Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, Ota-ku, Tokyo, Japan (YH).
Am J Phys Med Rehabil. 2019 Oct;98(10):866-871. doi: 10.1097/PHM.0000000000001206.
Gait variability changes before and after total hip arthroplasty are unclear. This study aimed to investigate gait variability changes in hip osteoarthritis patients before and after total hip arthroplasty and to examine the relationships between gait variability changes and hip function.
Twenty-three female patients with hip osteoarthritis (61.0 ± 7.1 yrs) and 10 healthy female participants (57.8 ± 3.9 yrs) were assessed 1 mo before and 12 mos after surgery. Heel and lower trunk accelerations were measured using two triaxial accelerometers. The coefficient of variation of stride time for gait variability of lower limb motions and the harmonic ratio for trunk variability were calculated. Radiographic leg-length discrepancy, hip abductor strength, hip abduction, extension range of motion, and pain level during gait were measured.
The coefficient of variation was significantly decreased after total hip arthroplasty and was comparable with that in healthy individuals. Although postoperative harmonic ratios were greater than preoperative harmonic ratios, they were not comparable with those in healthy individuals. The coefficient of variation changes were associated with pain relief during gait. Harmonic ratio changes were associated with hip abductor strength, extension range of motion, and limb lengthening.
Gait variability improved after total hip arthroplasty due to improved hip function. However, trunk variability was insufficient compared with that in healthy individuals.
全髋关节置换术前、后步态变异性的变化尚不清楚。本研究旨在探讨髋关节骨关节炎患者全髋关节置换术前、后步态变异性的变化，并探讨步态变异性变化与髋关节功能之间的关系。
23 名女性髋关节骨关节炎患者（61.0±7.1 岁）和 10 名健康女性参与者（57.8±3.9 岁）分别于术前 1 个月和术后 12 个月进行评估。使用两个三轴加速度计测量脚跟和下躯干的加速度。计算下肢运动步态变异性的步长时间变异系数和躯干变异性的调和比。测量放射学下肢长度差异、髋关节外展肌力量、髋关节外展、伸展运动范围和步态时的疼痛程度。
全髋关节置换术后，变异系数显著降低，与健康个体相当。尽管术后调和比大于术前调和比，但与健康个体仍不相当。变异系数的变化与步态时的疼痛缓解有关。调和比的变化与髋关节外展肌力量、伸展运动范围和肢体延长有关。
由于髋关节功能的改善，全髋关节置换术后步态变异性得到改善。然而，与健康个体相比，躯干变异性仍然不足。
