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足跟垫插入对全髋关节置换术后存在患者感知腿长差异患者步态功能的影响:一例病例报告。

Effect of heel lift insertion on gait function in a patient with total hip arthroplasty with patient-perceived leg length difference: a case report.

作者信息

Shiwa Toru, Kawabata Yuji, Ishii Takako, Anan Masaya

机构信息

Graduate School of Welfare Health Science, Oita University, Japan.

Department of Rehabilitation, Soejima Orthopedic Hospital, Japan.

出版信息

J Phys Ther Sci. 2024 Feb;36(2):81-86. doi: 10.1589/jpts.36.81. Epub 2024 Feb 1.

Abstract

[Purpose] The effect of heel lift insertion on gait in patients who have undergone total hip arthroplasty (THA) with patient-perceived leg length difference is seldom referenced in the literature. We used an AB design to investigate the alterations of gait function before and after inserting a heel lift on the non-operative side. [Participant and Methods] The participant had a patient-perceived leg length difference after THA and presented with gait disturbance. The survey phase was 10 days (phase A: normal physiotherapy for five days, and phase B: normal physiotherapy and heel lift insertion for another five days) from the 17th day following THA. The ambulatory task was conducted at a self-determined, comfortable pace and objectively assessed using an inertial sensor. [Results] The insertion of a heel lift partially improved the gait symmetry and the ratio of lumbar acceleration in three directions; it also corrected the patient-perceived leg length difference. [Conclusion] An investigation was carried out to examine the impact of a heel lift on gait in a single case of THA with patient-reported leg length difference. The application of a heel lift may enhance the relationship between the patient-perceived leg length difference, gait symmetry, and the ratio of lumbar acceleration in three dimensions.

摘要

[目的] 全髋关节置换术(THA)后患者自觉存在腿长差异时,足跟垫对步态的影响在文献中鲜有提及。我们采用AB设计来研究在非手术侧插入足跟垫前后步态功能的变化。[参与者与方法] 该参与者在全髋关节置换术后存在患者自觉腿长差异,并伴有步态障碍。调查阶段为全髋关节置换术后第17天起的10天(A阶段:进行5天常规物理治疗,B阶段:进行5天常规物理治疗并插入足跟垫)。以自定的舒适步速进行步行任务,并使用惯性传感器进行客观评估。[结果] 插入足跟垫部分改善了步态对称性以及三个方向的腰椎加速度比值;同时也纠正了患者自觉的腿长差异。[结论] 针对一例全髋关节置换术后存在患者报告腿长差异的病例,研究了足跟垫对步态的影响。足跟垫的应用可能会增强患者自觉腿长差异、步态对称性和三维腰椎加速度比值之间的关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbae/10830159/b24f367a3231/jpts-36-081-g001.jpg

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