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Lee Y, Shin S. Improvement of Gait in Patients with Stroke Using Rhythmic Sensory Stimulation: A Case-Control Study. J Clin Med 2022; 11:jcm11020425. [PMID: 35054122 PMCID: PMC8780685 DOI: 10.3390/jcm11020425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/03/2022] [Accepted: 01/11/2022] [Indexed: 12/14/2022] Open
Abstract
Patients with stroke suffer from impaired locomotion, exhibiting unstable walking with increased gait variability. Effects of rhythmic sensory stimulation on unstable gait of patients with chronic stroke are unclear. This study aims to determine the effects of rhythmic sensory stimulation on the gait of patients with chronic stroke. Twenty older adults with stroke and twenty age- and gender-matched healthy controls walked 60 m under four conditions: normal walking with no stimulation, walking with rhythmic auditory stimulation (RAS) through an earphone in the ear, walking with rhythmic somatosensory stimulation (RSS) through a haptic device on the wrist of each participant, and walking with rhythmic combined stimulation (RCS: RAS + RSS). Gait performance in the stroke group significantly improved during walking with RAS, RSS, and RCS compared to that during normal walking (p < 0.008). Gait variability significantly decreased under the RAS, RSS, and RCS conditions compared to that during normal walking (p < 0.008). Rhythmic sensory stimulation is effective in improving the gait of patients with chronic stroke, regardless of the type of rhythmic stimuli, compared to healthy controls. The effect was greater in patients with reduced mobility, assessed by the Rivermead Mobility Index (RMI).
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Affiliation(s)
- Yungon Lee
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan-si 38541, Korea;
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan-si 38541, Korea
- School of Kinesiology, College of Human Ecology & Kinesiology, Yeungnam University, 221ho, 280 Daehak-ro, Gyeongsan-si 38541, Korea
| | - Sunghoon Shin
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan-si 38541, Korea;
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan-si 38541, Korea
- School of Kinesiology, College of Human Ecology & Kinesiology, Yeungnam University, 221ho, 280 Daehak-ro, Gyeongsan-si 38541, Korea
- Correspondence: ; Tel.: +82-10-8940-2406
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Klasan A, Sen A, Dworschak P, El-Zayat BF, Ruchholtz S, Schuettler KF, Schmitt J, Heyse TJ. Ten-year follow-up of a cemented tapered stem. Arch Orthop Trauma Surg 2018; 138:1317-1322. [PMID: 30043147 DOI: 10.1007/s00402-018-3002-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION This stem was cleared by the FDA in 2002 and has been implanted in cementless and cemented versions. Despite its long history, there are no long-term clinical results available for the cemented version of this implant. The aim of this study was to provide such data. It was hypothesized that this implant delivers clinical success comparable to other tapered cemented stems. MATERIALS AND METHODS A total of 113 hip replacements were performed in 106 patients between October 2007 and December 2009 using the cemented version of this stem. The mean age of the patients at operation was 74.8 years (range 50-91 years). The mean follow-up was 8.9 years with only two patients lost to follow-up. Implant survival was determined using the Kaplan-Meier analysis. RESULTS Stem survival with revision for any reason as the endpoint was 96.4% after 10 years. Survival for stem aseptic loosening was 100%. There were no cases of osteolysis. Clinical outcomes, as shown by Harris Hip Scores, were in line with previous investigations and the rate of adverse events was very low. CONCLUSIONS This is a modern cemented stem with an excellent survival rate and satisfactory functional outcomes. In this cohort, there were no failures related to the stem through the first decade.
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Affiliation(s)
- Antonio Klasan
- Center for Orthopedics and Traumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany.
| | - Ahmet Sen
- Department for Trauma, Clinic Jung-Stilling, Wichernstraße 40, 57074, Siegen, Germany
| | - Philipp Dworschak
- Center for Orthopedics and Traumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany
| | - Bilal Farouk El-Zayat
- Center for Orthopedics and Traumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany
| | - Steffen Ruchholtz
- Center for Orthopedics and Traumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany
| | - Karl F Schuettler
- Center for Orthopedics and Traumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany
| | - Jan Schmitt
- Department for Orthopedics, Clinic Wetzlar, Forsthausstraße 1, 35578, Wetzlar, Germany
| | - Thomas J Heyse
- ORTHOmedic Frankfurt Offenbach, Herrnstr. 57, 63065, Offenbach, Germany
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Acker A, Fischer JF, Aminian K, Lécureux E, Jolles BM. Total hip arthroplasty using a cementless dual-mobility cup provides increased stability and favorable gait parameters at five years follow-up. Orthop Traumatol Surg Res 2017; 103:21-25. [PMID: 27890581 DOI: 10.1016/j.otsr.2016.09.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 09/20/2016] [Accepted: 09/28/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Rates of dislocation following primary total hip arthroplasty (THA) vary from 0.5 to 10%. Dual-mobility cups in THA demonstrate increased stability. Clinical outcomes following THA with dual-mobility cups have been reported, but gait has not been assessed. Therefore we performed a retrospective case control study to answer: (1) is gait better in patients following THA with a dual-mobility cup than in frail, elderly patients of the same age? (2) Are clinical outcomes better in patients following THA with a dual-mobility cup than in frail, elderly patients? (3) What is the dislocation rate following THA with a dual-mobility cup? HYPOTHESIS We hypothesized that patients who underwent THA with a dual-mobility cup have a better gait compared to frail, elderly patients of the same age. PATIENTS AND METHODS Twenty patients (22 hips), mean age 79.9±7.7 (range, 62.3-88.3) years were assessed in this retrospective case-control series 5.6±1.4 (range: 4.1-8.8) years following dual-mobility cup THA. A reference group consisted of 72 "frail elderly" patients in a rehabilitation hospital for health problems unrelated to the lower limb, with no lower limb surgery or neurological conditions. Temporal and spatial gait performance were measured with four miniature gyroscopes, mounted on each thigh and calf, while patients walked freely along a 30m corridor. Harris Hip Score, WOMAC, radiological outcomes, and dislocation rate were determined. RESULTS All gait parameters were better in the dual-mobility group compared to the frail elderly group. The dual-mobility group had a higher cadence (100.3 steps/minute versus 75.6 steps/minute), shorter (relative to gait cycle time) stance (61.6% versus 67.8%), shorter (relative to gait cycle time) double stance (23.3% versus 36.0%), longer stride (1.13m versus 0.80m), and faster walking speed (0.96m/s versus 0.52m/s). Range of motion of the shank, thigh and knee were better in the dual-mobility group. Harris Hip Score was 87.6±13.9 (range 51-100) and WOMAC score was 11.3±12.1 (range 0-34) in the THA group. We observed no dislocations. DISCUSSION Gait patterns five years following THA with the dual-mobility cup were better or comparable to published study populations. LEVEL OF EVIDENCE III, retrospective case-control series.
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Affiliation(s)
- A Acker
- Department of Orthopaedic Surgery and Traumatology, centre hospitalier universitaire vaudois (CHUV) and University of Lausanne, bureau HO/03/321, avenue Pierre-Decker 4, 1011 Lausanne, Switzerland
| | - J-F Fischer
- Department of Orthopaedic Surgery and Traumatology, établissements hospitaliers du nord vaudois (EHNV), rue d'Entremonts 11, 1400 Yverdon-les-Bains, Switzerland
| | - K Aminian
- Laboratory of Movement Analysis and Measurement, Interinstitutional Centre of Translational Biomechanics (STI CBT), École polytechnique fédérale de Lausanne, ELH 132, Station 11, 1015 Lausanne, Switzerland
| | - E Lécureux
- Department of Orthopaedic Surgery and Traumatology, centre hospitalier universitaire vaudois (CHUV) and University of Lausanne, bureau HO/03/321, avenue Pierre-Decker 4, 1011 Lausanne, Switzerland
| | - B M Jolles
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine (DAL), centre hospitalier universitaire vaudois (CHUV) and University of Lausanne, Bureau HO/03/321, avenue Pierre-Decker 4, 1011 Lausanne, Switzerland.
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Weber M, Weber T, Woerner M, Craiovan B, Worlicek M, Winkler S, Grifka J, Renkawitz T. The impact of standard combined anteversion definitions on gait and clinical outcome within one year after total hip arthroplasty. INTERNATIONAL ORTHOPAEDICS 2015; 39:2323-33. [PMID: 25920600 DOI: 10.1007/s00264-015-2777-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 03/23/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Different target areas within the concept of combined cup and stem anteversion have been published for total hip arthroplasty (THA). We asked whether component positioning according to eight standard combined anteversion rules is associated with (1) more physiological gait patterns, (2) higher improvement of gait variables and (3) better clinical outcome after THA. METHODS In a prospective clinical study, 60 patients received cementless THA through an anterolateral MIS approach in a lateral decubitus position. Six weeks postoperatively, implant position was analysed using 3D-CT by an independent external institute. Preoperatively, six and 12 months postoperatively range of motion, normalized walking speed and hip flexion symmetry index were measured using 3D motion-capture gait analysis. Patient-related outcome measures (HHS, HOOS, EQ-5D) were obtained by an observer blinded to 3D-CT results. Eight combined anteversion definitions and Lewinnek's "safe zone" were evaluated regarding their impact on gait patterns and clinical outcome. RESULTS Combined cup and stem anteversion according to standard combined anteversion definitions as well as cup placement within Lewinnek's "safe zone" did not influence range of motion, normalized walking speed and/or hip flexion symmetry index six and 12 months after THA. Similarly, increase of gait parameters within the first year after THA was comparable between all eight combined anteversion rules. Clinical outcome measures like HHS, HOOS and EQ-5D did not show any benefit for either of the combined anteversion definitions. CONCLUSIONS Standard combined cup and stem anteversion rules do not improve postoperative outcome as measured by gait analysis and clinical scores within one year after THA.
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Affiliation(s)
- Markus Weber
- Department of Orthopaedic Surgery, Regensburg University Medical Centre, Asklepios Klinikum Bad Abbach, Kaiser-Karl V.-Allee 3, 93077, Bad Abbach, Germany.
| | - Tim Weber
- Department of Orthopaedic Surgery, Regensburg University Medical Centre, Asklepios Klinikum Bad Abbach, Kaiser-Karl V.-Allee 3, 93077, Bad Abbach, Germany.,Regensburg Centre of Biomedical Engineering, Ostbayerische Technische Hochschule Regensburg, 93053, Regensburg, Germany
| | - Michael Woerner
- Department of Orthopaedic Surgery, Regensburg University Medical Centre, Asklepios Klinikum Bad Abbach, Kaiser-Karl V.-Allee 3, 93077, Bad Abbach, Germany
| | - Benjamin Craiovan
- Department of Orthopaedic Surgery, Regensburg University Medical Centre, Asklepios Klinikum Bad Abbach, Kaiser-Karl V.-Allee 3, 93077, Bad Abbach, Germany
| | - Michael Worlicek
- Department of Orthopaedic Surgery, Regensburg University Medical Centre, Asklepios Klinikum Bad Abbach, Kaiser-Karl V.-Allee 3, 93077, Bad Abbach, Germany
| | - Sebastian Winkler
- Department of Orthopaedic Surgery, Regensburg University Medical Centre, Asklepios Klinikum Bad Abbach, Kaiser-Karl V.-Allee 3, 93077, Bad Abbach, Germany
| | - Joachim Grifka
- Department of Orthopaedic Surgery, Regensburg University Medical Centre, Asklepios Klinikum Bad Abbach, Kaiser-Karl V.-Allee 3, 93077, Bad Abbach, Germany
| | - Tobias Renkawitz
- Department of Orthopaedic Surgery, Regensburg University Medical Centre, Asklepios Klinikum Bad Abbach, Kaiser-Karl V.-Allee 3, 93077, Bad Abbach, Germany
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