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Introduction: Gait before and after total hip arthroplasty (THA) is often determined by walking at preferred speed. However gait function comprises more than just walking at preferred speed. The objective is to describe recovery of gait after THA based on the assessment of spatio-temporal gait parameters determined with an ambulatory system whereby an extended test protocol is used.
Materials and Methods: Sixty-three patients participating in a short-stay program for primary unilateral THA were assessed preoperatively and at 6 weeks and 6 months postoperatively. The spatiotemporal gait parameters walking speed, step length, step duration and variability coefficient (VC) were determined with an ambulatory system using accelerometers. The test protocol contained walking at different speeds, walking while performing an additional cognitive task, and an endurance test.
Results: Patients improved significantly over time; however, the extent and speed of recovery of gait parameters was different 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 VC of the additional cognitive task part was comparable with the preferred walking VC. The endurance test results could be predicted from the results of preferred walking.
Conclusion: The assessment of the recovery of gait function requires more than only the 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.
Introduction: Despite growing awareness of the beneficial effects of physical activity on health, little is known about the amount of physical activity after THA. Although the WOMAC does not give direct information about the amount of physical activity it can be hypothesized that when patients experience limitations this will have an adverse effect on the amount of physical activity they are involved in. In this way the WOMAC can be predictive for the amount of physical activity. The aim of this study is to determine the correlation between the WOMAC and the amount of physical activity and to determine the predictive value of the WOMAC on meeting the (inter-) national guidelines of health -enhancing physical activity.
Materials and Methods: 364 patients with a THA (minimal one year postoperative) were included. Self-reported physical functioning was assessed by means of the WOMAC and the amount of physical activity by means of the SQUASH. Correlations between the WOMAC and SQUASH-scores were assessed using Pearson’s correlation coefficient. Binary logistic regression modelling was used to determine to which extent the score on the WOMAC was predictive in meeting the (inter-)national guidelines.
Results: A significant, low correlation between the WOMAC and SQUASH-scores (range 0.14 – 0.24) was found. Although the WOMAC was a significant predictor to meet the (inter-) national guidelines of physical activity (p<
0.001), the odds-ratio was low (1.022, 95%CI 1.0121.033). The Nagelkerke R2 was 0.069, implicating that 6.9% of the variance could be explained.
Conclusion: The WOMAC is not suitable to predict the amount of physical activity after THA, necessitating the use of additional quantitative outcome measures.