Shiwa Toru, Kawabata Yuji, Ishii Takako, Anan Masaya
Graduate School of Welfare Health Science, Oita University, Japan.
Department of Rehabilitation, Soejima Orthopedic Hospital, Japan.
J Phys Ther Sci. 2024 Feb;36(2):81-86. doi: 10.1589/jpts.36.81. Epub 2024 Feb 1.
[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.
[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。
