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Purpose: Patient recovery after a surgical procedure depends, among other factors, on the amount of the body weight with which patient loads lower limb. Research studies report different results of the degree of body weight with which lower limb is loaded during three-point crutch gait. The aim of this study was to evaluate the level of the ground reaction forces (GRF) during crutch gait used by patients after total hip arthroplasty (THA) in the first week after discharge from the orthopaedic units. Methods: Ten female patients diagnosed with primary unilateral coxarthrosis participated in a single measurement session. In order to record kinematic and dynamic variables of this gait pattern motion analysis system was used together with two force plates. The static test of body weight distribution between lower limbs was performed on a dual-top stabilometric plate. Results: The average peak values of loading on the operated (O) limb during mid stance and terminal stance of three-point crutch gait were 64.6% and 64.3% of body weight (BW), respectively, whereas in the case of the nonoperated (NO) limb 103.5%BW and 108.8%BW, respectively. The maximum loads on the crutches were significantly higher (by 9%BW) on the NO side as compared to the O side ( p < 0.05). During the static test, average values of body weight distribution on the O and NO limb were 36%BW and 64%BW, respectively. Conclusions: The patients showed surprisingly similar level of loading on the O limb. The weight bearing on the O limb was lower during static trial than during three-point crutch gait.
Czasopismo
Rocznik
Tom
Strony
131--135
Opis fizyczny
Bibliogr. 27 poz., tab., wykr.
Twórcy
autor
- Department of Biomechanics, University School of Physical Education, Poznań, Poland
autor
- Department of Physiotherapy and Biological Renovation, Stanisław Wojciechowski Higher Vocational State School, Kalisz, Poland
autor
- Department of Biomechanics, University School of Physical Education, Poznań, Poland
autor
- Department of Paediatric Rehabilitation, The Children’s Memorial Health Institute, Warsaw, Poland
autor
- Department of Biomechanics, University School of Physical Education, Poznań, Poland
Bibliografia
- [1] CHRISTIANSEN C.L., BADE M.J., WEITZENKAMP D.A., STEVENS-LAPSLEY J.E., Factors predicting weight-bearing asymmetry 1 month after unilateral total knee arthroplasty: a cross-sectional study, Gait Posture, 2013, Vol. 37(3), 363–367.
- [2] CICHY B., WILK M., ŚLIWIŃSKI Z., Changes in gait parameters in total hip arthroplasty patients before and after surgery, Med. Sci. Monit., 2008, Vol. 14(3), 159–169.
- [3] DESZCZYŃSKI J., STOLARCZYK A., Basic rehabilitation procedure of patients with total hip arthroplasty, Warsaw, Polish Society of Arthroscopic Surgery, 2008.
- [4] DWORAK L.B., MURAWA M., MĄCZYŃSKI J., OWSIAN M., KABACIŃSKI J., RZEPNICKA A., Three point crutch gait from the perspective of biomechanics and kinesiology. State of knowledge and idea behind the research, Pol. Orthop. Traumatol., 2011, Vol. 76(5), 305–312.
- [5] DWORAK L.B., MURAWA M., MĄCZYŃSKI J., Biomechanical analysis of two-point alternate crutch gait-comparison with standard gait, Pol. J. Phys., 2006, Vol. 6(4), 310–316.
- [6] DWORAK L.B., RZEPNICKA A., MURAWA M., MĄCZYŃSKI J., BUSZKO P., Swing-through gait from the perspective of biomechanics and kinesiology. Critical analysis of the current state of knowledge and the idea behind the research, Pol. Orthop. Traumatol., 2010, Vol. 75(6), 392–398.
- [7] EBERT J.R., LLOYD D.G., SMITH A., ACKLAND T., WOOD D.J., The association between external-ground-reaction force and knee-joint kinetics during partial- and full-weight-bearing gait, Clin. Biomech., 2010, Vol. 25(4), 359–364.
- [8] ENG K., RAO R., HOZACK W.J., SHARKEY P., Is partial weight bearing essential after uncemented total hip arthroplasty?, J. Arthroplasty, 2008, Vol. 13, 233.
- [9] GRAY F.B., GRAY C., MCCLANAHAN J.W., Assessing the accuracy of partial weight-bearing instruction, Am. J. Orthop., 1998, Vol. 27(8), 558–560.
- [10] GRIFFITH H., Complete Guide to Sports Injuries: How to Treat Fractures, Bruises, Sprains, Strains, Dislocations, Head Injuries, Perigee Books, 1997.
- [11] HOL A.M., VAN GRINSVEN S., LUCAS C., VAN SUSANTE J.L., VAN LOON C.J., Partial versus unrestricted weight bearing after an uncemented femoral stem in total hip arthroplasty: recommendation of a concise rehabilitation protocol from a systematic review of the literature, Arch. Orthop. Trauma Surg., 2010, Vol. 130(4), 547–555.
- [12] HURKMANS H.L., BUSSMANN J.B., BENDA E., VERHAAR J.A., STAM H.J., Techniques for measuring weight bearing during standing and walking, Clin. Biomech., 2003, Vol. 18(7), 576–589.
- [13] HURKMANS H.L., BUSSMANN J.B., SELLES R.W., BENDA E., STAM H.J., VERHAAR J.A., The difference between actual and prescribed weight bearing of total hip patients with a trochanteric osteotomy: long-term vertical force measurements inside and outside the hospital, Arch. Phys. Med. Rehabil., 2007, Vol. 88(2), 200–206.
- [14] LI S., ARMSTRONG C.W., CIPRIANI D., Three-point gait crutch walking: variability in ground reaction force during weight bearing, Arch. Phys. Med. Rehabil., 2001, Vol. 82(1), 86–92.
- [15] LISIŃSKI P., GRONEK A., SAMBORSKI W., DWORAK L.B., Proposal for a rehabilitation regimen for patients after posterior cruciate ligament reconstruction surgery. A model of biomechanical study of the rehabilitation process, Pol. J. Phys., 2010, Vol. 10(1), 1–11.
- [16] MALVIYA A., RICHARDS J., JONES R.K., UDWADIA A., DOYLE J., Reproducibilty of partial weight bearing, Injury, 2005, Vol. 36(4), 556–559.
- [17] MCCRORY J.L., SCOTT C., WHITE S.C., LIFESO R.M., Vertical ground reaction forces: objective measures of gait following hip arthroplasty, Gait Posture, 2001, Vol. 14(2), 104–109.
- [18] NOWOTNY-CZUPRYNA O., NOWOTNY J., SOŁTYS J., BRZĘK A., CZUPRYNA K., DĄBROWSKA J., Possibilities of one leg relief while walking on crutches, Physiotherapy, 2005, Vol. 13(3), 48–56.
- [19] POZOWSKI A., ŚCIGAŁA K., KIERZEK A., PAPROCKA-BOROWICZ M., KUCIEL-LEWANDOWSKA J., Analysis of the influence of a metha-type metaphysical stem on biomechanical parameters, Acta Bioeng. Biomech., 2013, Vol. 15(2), 13–21.
- [20] SOUTHALL V.H., Guidelines for Specialized Health Care Procedures, Richmond, Virginia Department of Health, 2004.
- [21] STEWART K.B., How to use crutches correctly, Nursing, 1997, Vol. 27(5), 20–22.
- [22] TRUSZCZYŃSKA A., RĄPAŁA K., GMITRZYKOWSKA E., TRZASKOMA Z., DRZAŁ-GRABIEC J., Postural stability disorders in patients with osteoarthritis of the hip, Acta Bioeng. Biomech., 2014, Vol. 16(1), 45–50.
- [23] TVEIT M., KARRHOLM J., Low effectiveness of prescribed partial weight bearing: continous recording of vertical loads using a new pressure-sensitive insole, J. Rehabil. Med., 2001, Vol. 33(1), 42–46.
- [24] VASARHELYI A., BAUMERT T., FRITSCH C., HOPFENMULLER W., GRADL G., MITTLMEIER T., Partial weight bearing after surgery for fractures of the lower extremity – is it achievable?, Gait Posture, 2006, Vol. 23(1), 99–105.
- [25] WINIARSKI S., RUTKOWSKA-KUCHARSKA A., Estimated ground reaction force in normal and pathological gait, Acta Bioeng. Biomech., 2009, Vol. 11(1), 53–60.
- [26] WOOLSON S.T., ADLER N.S., The effect of partial or full weight bearing ambulation after cementless total hip arthroplasty, J. Arthroplasty, 2002, Vol. 17(7), 820–825.
- [27] YOUDAS J.W., KOTAJARVI B.J., PADGETT D.J., KAUFMAN K.R., Partial weight-bearing gait using conventional assistive devices, Arch. Phys. Med. Rehabil., 2005, Vol. 86(3), 394–398.
Uwagi
PL
Opracowanie ze środków MNiSW w ramach umowy 812/P-DUN/2016 na działalność upowszechniającą naukę.
Typ dokumentu
Bibliografia
Identyfikator YADDA
bwmeta1.element.baztech-e3558f3d-8a8f-4724-8220-817718b208fd