1
|
Tokuyasu H, Tsushima E, Takemoto M, Vergari C, Tada H, Kim Y. The Impact of Spinopelvic and Hip Mobility on Passive Hip Flexion Range of Motion Assessment. Arthroplast Today 2024; 29:101429. [PMID: 39328882 PMCID: PMC11424763 DOI: 10.1016/j.artd.2024.101429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/03/2024] [Accepted: 05/01/2024] [Indexed: 09/28/2024] Open
Abstract
Background Measuring passive hip flexion range of motion (ROM) is challenging due to compensatory movements. Despite the interest in using functional lateral radiographs for assessing hip mobility, the relationship with passive hip flexion ROM remains unclear. This study aims to elucidate this relationship and clarify spinopelvic parameters and mobility factors influencing variations in passive and radiographic hip flexion ROM. Methods A retrospective cross-sectional study was conducted on 154 preoperative patients undergoing primary total hip arthroplasty. Passive and radiographic hip flexion ROM were assessed to clarify these relationships, and these differences were classified into 3 groups (O, A and U). Spinopelvic and hip parameters were assessed in standing, relaxed-seated and flexed-seated positions, as well as lumbar, pelvis, and hip mobility between each position to identify factors influencing differences. Results There was a moderate correlation between passive and radiographic hip flexion ROM (R2 = 0.48, P < .01). A significant difference was found in pelvic and hip alignment in the flexed-seated position between all groups. In postural changes, the O group, which had more patients with relatively low hip mobility, showed greater lumbar spine and pelvic movement, while the U group, which had more patients with relatively high hip mobility, showed less lumbar spine and pelvic movement. Conclusions This study confirmed that passive hip flexion ROM and radiographic hip flexion ROM correlate and that spinopelvic and hip alignment and mobility influence these differences. This result suggests that clinicians should consider lumbar and pelvic alignment and mobility in clinical practice to improve the accuracy of passive hip flexion ROM measurements.
Collapse
Affiliation(s)
- Hiroyuki Tokuyasu
- Department of Rehabilitation, Kyoto City Hospital, Kyoto, Japan
- Graduate School of Health Sciences, Hirosaki University, Hirosaki, Aomori, Japan
| | - Eiki Tsushima
- Graduate School of Health Sciences, Hirosaki University, Hirosaki, Aomori, Japan
| | - Mitsuru Takemoto
- Department of Orthopaedic Surgery, Kyoto City Hospital, Kyoto, Japan
| | - Claudio Vergari
- Arts et Métiers Institute of Technology, Institut de Biomécanique Humaine Georges Charpak, Université Sorbonne Paris Nord, Paris, France
| | - Hiroshi Tada
- Department of Rehabilitation, Kyoto City Hospital, Kyoto, Japan
| | - Youngwoo Kim
- Department of Orthopaedic Surgery, Kyoto City Hospital, Kyoto, Japan
| |
Collapse
|
2
|
Yamada K, Shimizu H, Doi N, Harada K, Ishizuka-Inoue M, Yamashita R, Takamatsu S, Hayashi-Nishiyama S, Okamoto Y, Aoyama T. Usefulness and safety of a wearable transcutaneous electrical nerve stimulation device for promoting exercise therapy in patients with chronic knee pain: A randomized controlled trial. Arch Phys Med Rehabil 2024:S0003-9993(24)01226-7. [PMID: 39251034 DOI: 10.1016/j.apmr.2024.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 07/09/2024] [Accepted: 08/12/2024] [Indexed: 09/11/2024]
Abstract
OBJECTIVE To investigate the effect of transcutaneous electrical nerve stimulation (TENS) in reducing barriers to the implementation of exercise therapy and promoting exercise therapy, focusing on physical activity. DESIGN A single, participant-blinded, randomized controlled trial (RCT) with a pre-post design SETTING: Single-institution, orthopedic clinic PARTICIPANTS: Participants had knee pain for at least 3 months (N=63, ≥50 years of age) and were randomly assigned to the TENS (N=21), exercise (N=23), or combined (N=19) group. INTERVENTIONS Participants were provided with 4 weeks of intervention: the TENS group using a wearable TENS device, exercise group performing designated exercises, and combined group performing activities from the TENS and exercise groups. MAIN OUTCOME MEASURES The primary outcome measure was physical activity (PA). The secondary outcome measures were 6-minute walk test (6MWT); timed up-and-go test (TUG); stair climbing; knee pain using the visual analog scale at 6MWT, TUG, and stair climbing; and patient-reported changes in knee pain over time. RESULTS At pre- and post-intervention, light-intensity PA time (LPA) in the TENS, exercise, and combined groups was 735.62±68.82 vs. 714.21±73.06 (p=0.061), 733.05±103.90 vs. 700.31±90.33 (p=0.057), and 710.09±62.98 vs. 685.22±58.35 (p=0.049), respectively, with a significant decrease in the combined group. Significant improvement in knee pain and stair climbing was observed in all groups pre- and post-intervention. CONCLUSIONS The group using TENS showed improved effects of early reduction in knee pain and when combined with exercise therapy, a reduction in time spent in light-intensity activities such as sedentary behavior. Thus, the use of TENS in combination with conventional exercise therapy has the potential to reduce psychological barriers to the introduction of exercise therapy. It also promotes and ensures the safe implementation and continuation of exercise therapy.
Collapse
Affiliation(s)
- Keisuke Yamada
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Technology Development HQ, Strategic Clinical R&D Department, Omron Healthcare Co., Ltd, Kyoto, Japan
| | - Hiroki Shimizu
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoki Doi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Keiko Harada
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mami Ishizuka-Inoue
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Reika Yamashita
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shozo Takamatsu
- Technology Development HQ, Strategic Clinical R&D Department, Omron Healthcare Co., Ltd, Kyoto, Japan
| | - Saki Hayashi-Nishiyama
- Technology Development HQ, Strategic Clinical R&D Department, Omron Healthcare Co., Ltd, Kyoto, Japan
| | | | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| |
Collapse
|
3
|
Unuvar BS, Tufekci O, Gercek H, Torlak MS, Erbas O. Comparison of muscle tightness between knees in individuals with unilateral osteoarthritis and its relationship with pain and function. J Back Musculoskelet Rehabil 2024; 37:1269-1276. [PMID: 38517773 DOI: 10.3233/bmr-230373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
BACKGROUND Unilateral osteoarthritis (OA) affects single knees and presents a unique scenario where individuals experience varying degrees of symptoms between their affected and unaffected knees. OBJECTIVE This study aims to investigate differences in muscle tightness between symptomatic and asymptomatic knees in individuals with unilateral knee OA while exploring the interplay among pain, functionality, and muscle tightness. METHODS In this cross-sectional study, thirty knee OA patients underwent assessments for hamstring (Active Knee Extension, Straight Leg Raise), iliotibial band (Ober Test), and quadriceps tightness (Modified Thomas Test). Pain intensity was measured using the Visual Analog Scale (VAS), and functional limitations were evaluated via the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). RESULTS A negative correlation was observed between participants' pain and AKE (p= 0.004, r=-0.515), ASLR (p= 0.27, r=-0.403), Ober (p= 0.010, r=-0.461) values. However, no significant correlation was found with the Modified Thomas value (p= 0.204, r=-0.239). There was also a negative correlation between participants' WOMAC scores and AKE (p= 0.019, r=-0.427), OBER (p= 0.004, r=-0.510), and Modified Thomas (p= 0.022, r=-0.416) values, while ASLR (p= 0.286, r=-0.202) values showed no significant correlation. Comparisons between AKE, Ober, and Modified Thomas values showed higher values in asymptomatic extremities (AKE: p= 0.025, Ober: p= 0.021, Modified Thomas: p= 0.030). CONCLUSION This study emphasizes the significance of muscle tightness in the symptomatic extremities of individuals with unilateral knee OA. The results indicate that increased muscle tightness makes pain worse and limits movement. It's crucial for healthcare providers treating OA to focus on improving muscle flexibility, reducing pain, and enhancing overall function.
Collapse
Affiliation(s)
- Bayram Sonmez Unuvar
- Department of Audiology, Faculty of Health Sciences, KTO Karatay University, Konya, Turkey
| | | | - Hasan Gercek
- Department of Therapy and Rehabilitation, Vocational School of Health Services, KTO Karatay University, Konya, Turkey
| | - Mustafa Savas Torlak
- Department of Therapy and Rehabilitation, Vocational School of Health Services, KTO Karatay University, Konya, Turkey
| | - Onur Erbas
- Health Sciences Institute, Karamanoğlu Mehmetbey University, Karaman, Turkey
| |
Collapse
|
4
|
de Sire A, Marotta N, Spanó R, Fasano S, Sgro M, Lippi L, Invernizzi M, Ammendolia A. Efficacy of proprioceptive neuromuscular facilitation on functioning in patients with bilateral hip osteoarthritis: A pilot randomized controlled trial. J Back Musculoskelet Rehabil 2024; 37:445-457. [PMID: 37955078 DOI: 10.3233/bmr-230148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
BACKGROUND Hip osteoarthritis (OA) is a chronic progressive disease that impresses a noticeable burden to society and healthcare systems. Physical exercise constitutes the first-line hip OA treatment approach, nevertheless, there is currently no gold standard method to treat this disease. OBJECTIVE To evaluate the efficacy of proprioceptive neuromuscular facilitation (PNF) on functioning in patients with hip OA. METHOD A pilot randomized controlled trial (RCT) was carried out on patients with painful bilateral hip OA with a body mass index (BMI) < 30 kg/m2. After the randomization, the experimental group was treated with PNF protocol and the control group with conventional physical therapy (10 sessions of manual therapy, 5 sessions/week for 2 weeks). The Harris Hip Score (HHS) was the primary outcome, whereas we assessed as secondary outcomes: pain, range of motion, and muscle strength of hip, physical performance, and quality of life. RESULTS Twenty patients (40 hips) were enrolled and randomized into two groups: PNF group (mean age: 70.7 ± 8.07; BMI: 25.1 ± 3.07; 7 females and 3 males) and control group (mean age: 74.9 ± 10.72; BMI: 26.8 ± 3.78; 6 females and 4 males). The results showed a statistically significant improvement of HHS in the study group (T1: 90.6 ± 5.63) than in the control group (T1: 77.3 ± 10.9) (between-group p value < 0.001). Three months after the treatment we have statistically significant maintenance in the PNF group (T2:89.6±6.32, within-group ΔT0-T2 p< 0.01) while the control group did not maintain the improvements recorded at T1 (T2: 71.4 ± 15.8). CONCLUSION The results of this pilot RCT showed that incorporating PNF exercises into the rehabilitation program yielded notable enhancements in improving lower limb function, strength and ROM in hip OA patients. Nonetheless, further prospective studies including wider sample size are needed to implement scientific knowledge on this physical therapy approach, in patients with hip osteoarthritis.
Collapse
Affiliation(s)
- Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Nicola Marotta
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Department of Experimental and Clinical Medicine, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Riccardo Spanó
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- S. Anna Institute, Crotone, Italy
| | - Stefano Fasano
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Maria Sgro
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont "A. Avogadro", Novara, Italy
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| |
Collapse
|
5
|
Tanaka H, Yamada N, Kurishima H, Mori Y, Sakamoto T, Oyama M. The intraoperative hip range of motion in total hip arthroplasty predicts postoperative patient's satisfaction for cutting toenails and putting on sock. J Orthop Sci 2022; 27:1060-1066. [PMID: 34246529 DOI: 10.1016/j.jos.2021.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/26/2021] [Accepted: 06/02/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Restricted hip range of motion (ROM) has been proposed as a useful diagnostic tool for osteoarthritis. The relations between the intraoperative hip ROM under anesthesia in total hip arthroplasty (THA) and recovery of clinical mobility outcomes were unclear. This study evaluated the association between the intraoperative hip ROM under anesthesia in THA and the postoperative recovery of clinical mobility, including cutting toenails and putting on socks after THA. METHODS The study was performed as a prospective cohort study and included 93 hips in 85 patients who underwent primary anterior-based muscle-sparing THA in the supine position. The hip ROM was evaluated under anesthesia before skin incision and intraoperative stability test. The Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ) was evaluated. A questionnaire on whether and how patients could cut toenails and putting on socks was assessed. The relationship between hip ROM at intraoperative stability tests and JHEQ moving score, cutting toenails, and putting on socks scores were evaluated statistically. RESULTS We observed a week positive correlation between intraoperative hip ROM and the total of JHEQ mobility score. A moderate positive correlation was observed between external rotation angle with flexion 90°and cutting toenails and putting on socks score oh JHEQ. 94.6% and 96.8% of the patients could cut their toenails and putting on socks by themselves after surgery. The optimum cutoff range for high patient satisfaction for putting on socks and cutting toenails was 110° for flexion and 35°-40° for the external rotation angle in the intraoperative stability test. CONCLUSION Hip ROM during intraoperative stability testing, especially the external rotation angle can predict postoperative outcomes and patient satisfaction for cutting toenails and putting on socks. We suggested that the capsule or capsular ligament release around the hip was increased to provide sufficient ROM without compromising stability.
Collapse
Affiliation(s)
- Hidetatsu Tanaka
- Department of Orthopaedic Surgery, Japanse Redcross Sendai Hospital, 43-3, 2 Cho-me, Yagiyama Hon-cho, Taihaku-ku, Sendai 982-8501, Japan.
| | - Norikazu Yamada
- Department of Orthopaedic Surgery, Japanse Redcross Sendai Hospital, 43-3, 2 Cho-me, Yagiyama Hon-cho, Taihaku-ku, Sendai 982-8501, Japan
| | - Hiroaki Kurishima
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Yu Mori
- Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Takashi Sakamoto
- Department of Orthopaedic Surgery, Japanse Redcross Sendai Hospital, 43-3, 2 Cho-me, Yagiyama Hon-cho, Taihaku-ku, Sendai 982-8501, Japan
| | - Masamizu Oyama
- Department of Orthopaedic Surgery, Japanse Redcross Sendai Hospital, 43-3, 2 Cho-me, Yagiyama Hon-cho, Taihaku-ku, Sendai 982-8501, Japan
| |
Collapse
|
6
|
Retchford TH, Tucker KJ, Hart HF, Semciw AI, Weinrauch P, Grimaldi A, Cowan SM, Crossley KM, Kemp JL. No Difference in Hip Muscle Volumes and Fatty Infiltration in Those With Hip-Related Pain Compared to Controls. Int J Sports Phys Ther 2022; 17:851-862. [PMID: 35949368 PMCID: PMC9340835 DOI: 10.26603/001c.36528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/09/2022] [Indexed: 11/18/2022] Open
Abstract
Background Little is known about muscle morphology in people with hip-related pain, without signs of femoro-acetabular impingement syndrome (FAIS). Identifying changes in hip muscle volume, fatty infiltrate and establishing relationships between muscle volume and strength, may provide insight into potential early treatment strategies. Purposes To: (i) compare the volumes and fatty infiltrate of gluteus maximus, gluteus medius, gluteus minimis, tensor fascia latae and quadratus femoris between symptomatic and less-symptomatic sides of participants with hip-related pain; (ii) compare the volumes and fatty infiltrate of hip muscles between healthy controls and symptomatic participants; and (iii) explore relationships of hip muscle volumes to muscle strength and patient-reported outcome measures in people with hip-related pain. Study Design Cross-sectional study. Methods Muscle volume and fatty infiltrate (from magnetic resonance imaging), hip muscle strength, patient-reported symptoms, function and quality of life (QOL) were determined for 16 participants with hip-related pain (no clinical signs of FAIS; 37±9 years) and 15 controls (31±9 years). Using One Way Analysis of Co-Variance tests, muscle volume and fatty infiltrate was compared between the symptomatic and less-symptomatic sides in participants with hip-related pain as well as between healthy controls and symptomatic participants. In addition, hip muscle volume was correlated with hip muscle strength, hip-reported symptoms, function and QOL. Results No differences in all the studied muscle volumes or fatty infiltrate were identified between the symptomatic and less-symptomatic hips of people with hip-related pain; or between people with and without hip-related pain. Greater GMED volume on the symptomatic side was associated with less symptoms and better function and QOL (ρ=0.522-0.617) for those with hip-related pain. Larger GMAX volume was associated with greater hip abduction and internal rotation strength, larger GMED volume was associated with greater hip extension strength, and larger QF volume was associated with greater hip abduction strength (rho=0.507-0.638). Conclusion People with hip-related pain and no clinical signs of FAIS have hip muscle volumes that are not significantly different than those of matched pain-free controls or their less-symptomatic hip. Larger GMED muscle volume was associated with fewer symptoms and greater strength. Level of evidence Level 3a.
Collapse
Affiliation(s)
| | | | - Harvi F Hart
- La Trobe University; Bone and Joint Institute, Western University
| | - Adam I Semciw
- La Trobe University; Northern Centre for Health, Education and Research- The Northern Hospital
| | | | | | | | | | | |
Collapse
|
7
|
Three-dimensional foot trajectory in female patients with end-stage hip osteoarthritis during walking. Sci Rep 2022; 12:9843. [PMID: 35701555 PMCID: PMC9198095 DOI: 10.1038/s41598-022-14070-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 05/31/2022] [Indexed: 12/02/2022] Open
Abstract
Osteoarthritis (OA) is a risk factor for falls. To decrease the fall risk, it is important to evaluate the detailed features of the gait of patients with OA. This study aimed to investigate the spatio-temporal parameters of gait in patients with end-stage hip OA, especially foot trajectory. We measured normal speed gait in patients with hip OA and in healthy controls (HCs) using inertial measurement units attached to shanks. The stride lengths in the affected and unaffected sides in the patients with hip OA were shorter than those in the HCs, but the position of maximum foot clearance was not significantly different between the two groups. The patients with hip OA compensated the position of maximum foot clearance to avoid fall risk. The horizontal plane foot trajectory in patients with hip OA suggests that the lateral bending of the trunk during walking, which is frequently seen in them, was a result of the lateral distance at swing down being located significantly more medially on the unaffected side than on the affected side. Herein, a new gait parameter of lateral distance at swing was discovered by a detailed evaluation of three-dimensional foot trajectory of female patients with end-stage hip OA.
Collapse
|
8
|
Prieto-Moreno R, Estévez-López F, Molina-Garcia P, Mora-Traverso M, Deschamps K, Claeys K, de Buyser J, Ariza-Vega P. ActiveHip+: A feasible mHealth system for the recovery of older adults after hip surgery during the COVID-19 pandemic. Digit Health 2022; 8:20552076221139694. [PMID: 36420319 PMCID: PMC9677169 DOI: 10.1177/20552076221139694] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/01/2022] [Indexed: 08/03/2023] Open
Abstract
OBJECTIVE Half of older adults undergoing hip surgery do not recover their previous functional status. mHealth is a promising tool for rehabilitating older adults after hip surgery. This study aimed to test the feasibility of the ActiveHip+ mHealth system in older adults after hip surgery. METHODS Sixty-nine older adults who had undergone hip surgery and their family caregivers were recruited from hospitals in Spain and Belgium and used the ActiveHip+ mHealth system for 12 weeks. Assessments were made during hospital stay and 3 months after surgery. Feasibility assessment included: adoption (participation proportion), usage (access to the app), satisfaction with the app (Net Promoter Score) and user perception of the quality of the app (Mobile App Rating Scale). Clinical assessment included: patient-reported outcomes, such as functional status (Functional Independence Measure) and performance-based outcomes, such as physical fitness (Short Physical Performance Battery). RESULTS The ActiveHip+ mHealth system obtained satisfactory feasibility results in both countries. In Spain, we observed 85% adoption, 64% usage, 8.86/10 in satisfaction with the app and 4.42/5 in perceived quality of the app. In Belgium, we observed 82% adoption, 84% usage, 5.16/10 in satisfaction with the app and 3.52/5 in app's perceived quality. The intervention had positive effects on levels of functional status, pain and physical fitness. CONCLUSIONS The ActiveHip+ mHealth system is a feasible tool to conduct the rehabilitation in older adults after hip surgery. Although the intervention seemed beneficial clinically, we do not recommend its implementation in clinical settings until appropriately designed randomised clinical trials confirm these results.
Collapse
Affiliation(s)
- Rafael Prieto-Moreno
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain
| | - Fernando Estévez-López
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Pablo Molina-Garcia
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain
| | - Marta Mora-Traverso
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain
| | - Kevin Deschamps
- Department of Rehabilitation Sciences, KU Leuven, Musculoskeletal Rehabilitation Research Group, Campus Brugge, Leuven, Flanders, Belgium
- Clinical Motion Analysis Laboratorium, University Hospitals Leuven, Campus Pellenberg, Leuven, Flanders, Belgium
- Division of Podiatry, Haute Ecole Leonard De Vinci, Institut D’Enseignement Supérieur Parnasse Deux-Alice, Bruxelles, Belgium
- Department of Podiatry, Artevelde University College, Gent, Belgium
| | - Kurt Claeys
- Department of Rehabilitation Sciences, KU Leuven, Musculoskeletal Rehabilitation Research Group, Campus Brugge, Leuven, Flanders, Belgium
| | - Janou de Buyser
- Department of Rehabilitation Sciences, KU Leuven, Musculoskeletal Rehabilitation Research Group, Campus Brugge, Leuven, Flanders, Belgium
| | - Patrocinio Ariza-Vega
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain
- Department of Physiotherapy, Faculty of Health Science, University of Granada, Granada, Spain
| |
Collapse
|
9
|
Tani T, Ando W, Hamada H, Takao M, Sugano N. Hip subluxation and osteophye morphology are related to coronal contracture of the hip. J Orthop Res 2021; 39:1691-1699. [PMID: 33095496 DOI: 10.1002/jor.24891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/10/2020] [Accepted: 10/21/2020] [Indexed: 02/04/2023]
Abstract
Coronal hip contracture induces pelvic obliquity in the presence of hip osteoarthritis (HOA), followed by the functional leg-length discrepancy. To promote accurate diagnosis of contracture and proper management of soft tissue release in total hip arthroplasty (THA), this study aimed to clarify the morphological features on plain radiographs that are related to contracture in patients with HOA. Two hundred forty-three hips of 231 patients with HOA who underwent primary THA were included in this study. Preoperative pelvic radiographs of the bilateral hips in maximum adduction and abduction were used to quantify contracture. Patients were grouped according to their contracture as having abduction contracture, adduction contracture, or minimal contracture. We investigated HOA, subluxation, anatomical factors, spinal factors, and the morphology of osteophytes at the inferomedial femoral head and compared parameters among groups to clarify the predictors of contracture. Eighteen hips (7.6%) were classified as having adduction contracture and 23 (9.4%) as having abduction contracture. Crowe classification, leg-length discrepancy, and osteophyte morphology showed significant correlations with adduction contracture. Factors significantly correlated with abduction contracture were offset difference, pelvic obliquity, functional femoral anteversion, and osteophyte morphology. Multivariate logistic regression analysis showed that the factor most strongly related to adduction contracture was Crowe III classification, whereas the strongest predictor of abduction contracture was osteophyte morphology. In conclusion, hip subluxation was related to the adduction contracture of the hip, whereas osteophyte morphology was related to abduction contracture.
Collapse
Affiliation(s)
- Tetsuro Tani
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Suita, Japan
| | - Wataru Ando
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hidetoshi Hamada
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masaki Takao
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Nobuhiko Sugano
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Suita, Japan
| |
Collapse
|
10
|
Tateuchi H, Akiyama H, Goto K, So K, Kuroda Y, Ichihashi N. Strategies for increasing gait speed in patients with hip osteoarthritis: their clinical significance and effects on hip loading. Arthritis Res Ther 2021; 23:129. [PMID: 33910597 PMCID: PMC8080338 DOI: 10.1186/s13075-021-02514-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 04/19/2021] [Indexed: 01/24/2023] Open
Abstract
Background Changes in gait speed are required in various situations and can be achieved by changing stride length, cadence, or both. Differences in strategies for increasing gait speed may have different effects on hip joint and physical function. The purpose of this study was to determine the effects of strategies for increasing gait speed on hip pain, physical function, and changes in hip loading during gait in patients with hip osteoarthritis (OA). We hypothesized that patients who increase gait speed mainly by increasing cadence would have lesser hip pain, a higher physical function, and a lower rate of increase in hip moments with increasing gait speed. Methods Forty-seven patients with secondary hip OA (age, 48.3 ± 11.0 years) were included. Gait speed, stride length, cadence, and peak and impulse of the hip moments were measured during gait at self-selected normal and fast gait speeds. The patients were classified as types S (with mainly increasing stride length, n = 11 [23.4%]), C (with mainly increasing cadence, n = 23 [48.9%]), and SC (with increasing stride length and cadence, n = 13 [27.7%]) according to whether they used changes in stride length and/or cadence to transition from normal to fast gait. Hip pain, physical function, and hip moment changes during gait were compared between types. Results The physical function was higher in types C (38.0 ± 8.8, P = 0.018) and SC (40.6 ± 8.5, P = 0.015) than in type S (28.2 ± 7.8), even after adjustment for age and minimum joint space width. Hip pain was not significantly different between types. The robustness of these results was confirmed with sensitivity analysis. The rates of increases in peak external hip adduction (P = 0.003) and internal rotation moments (P = 0.009) were lower in type C than in type SC. Conclusions Type C tended to suppress the increase in hip moments during fast gait. Types C and SC, which included increased cadence, maintained higher physical function levels than type S. Encouraging the use of cadence-increasing strategy may be useful for reducing hip loading and maintaining physical function in patients with hip OA. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-021-02514-x.
Collapse
Affiliation(s)
- Hiroshige Tateuchi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Haruhiko Akiyama
- Department of Orthopaedic Surgery, School of Medicine, Gifu University, Gifu, Japan
| | - Koji Goto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazutaka So
- Department of Orthopaedic Surgery, Osaka Red Cross Hospital, Osaka, Japan
| | - Yutaka Kuroda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriaki Ichihashi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| |
Collapse
|
11
|
John S, Weizel D, Heumann AS, Fischer A, Orlowski K, Mrkor KU, Edelmann-Nusser J, Witte K. Persisting inter-limb differences in patients following total hip arthroplasty four to five years after surgery? A preliminary cross-sectional study. BMC Musculoskelet Disord 2021; 22:230. [PMID: 33639901 PMCID: PMC7916281 DOI: 10.1186/s12891-021-04099-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Total hip arthroplasty (THA) is an effective procedure for patients with end-stage hip osteoarthritis. However, whether or not pre-operatively existing functional deficits are persisting several years post-surgery in the affected limb has not been thoroughly researched. Therefore, the primary aim of this preliminary study was to include patients four to five years after undergoing THA and to investigate potential differences between the operated and non-operated leg in hip strength, range of motion (ROM), balance, and gait. The secondary aim was to compare these values from the operated leg of the patients to those of the legs of healthy subjects. METHODS Sixteen patients (age: 65.20 ± 5.32 years) following unilateral THA (post-operation time: 4.7 ± 0.7 years) and ten, healthy, age-matched control subjects (age: 60.85 ± 7.57 years) were examined for maximum isometric hip muscle strength, active ROM of the hip joint, balance and gait on both limbs. Paired t-tests were used to assess the inter-limb differences in the THA group. Analyses of covariance (ANCOVA) were performed to compare groups, using age as a covariate. RESULTS The analysis of inter-limb differences in patients following THA revealed significant deficits on the operated side for hip abduction strength (p = 0.02), for hip flexion ROM (p < 0.01) and for balance in terms of the length of center of pressure (COP) (p = 0.04). Compared to values of the control subjects, the patients demonstrated significantly reduced hip strength in flexion, extension and abduction (p < 0.05) on the operated leg as well as reduced ROM measures in hip flexion, extension and abduction (p < 0.05). CONCLUSIONS The first results of this explorative study indicated that inter-limb differences as well as reduced hip strength and hip ROM compared with control subjects were still present four to five years after THA. These persisting asymmetries and deficits in patients following THA may be one explanation for the decrease in health-related quality of life (HRQoL) seen in patients over the years after surgery. Further studies are required to replicate these findings with a larger sample size. TRIAL REGISTRATION DRKS, DRKS00016945. Registered 12 March 2019 - Retrospectively registered.
Collapse
Affiliation(s)
- Stefanie John
- Sports Science, Faculty of Humanities, Otto-von-Guericke-University, Zschokkestraße 32, 39104, Magdeburg, Germany.
| | - David Weizel
- Sports Science, Faculty of Humanities, Otto-von-Guericke-University, Zschokkestraße 32, 39104, Magdeburg, Germany
| | - Anna S Heumann
- Sports Science, Faculty of Humanities, Otto-von-Guericke-University, Zschokkestraße 32, 39104, Magdeburg, Germany
| | - Anja Fischer
- Sports Science, Faculty of Humanities, Otto-von-Guericke-University, Zschokkestraße 32, 39104, Magdeburg, Germany
| | - Katja Orlowski
- Department of Computer Science and Media, Brandenburg University of Applied Sciences, Magdeburger Straße 50, 14770, Brandenburg an der Havel, Germany
| | - Kai-Uwe Mrkor
- Department of Computer Science and Media, Brandenburg University of Applied Sciences, Magdeburger Straße 50, 14770, Brandenburg an der Havel, Germany
| | - Jürgen Edelmann-Nusser
- Sports Science, Faculty of Humanities, Otto-von-Guericke-University, Zschokkestraße 32, 39104, Magdeburg, Germany
| | - Kerstin Witte
- Sports Science, Faculty of Humanities, Otto-von-Guericke-University, Zschokkestraße 32, 39104, Magdeburg, Germany
| |
Collapse
|
12
|
Assogba TF, Niama-Natta DD, Kpadonou TG, Lawson T, Mahaudens P, Detrembleur C. Disability and functioning in primary and secondary hip osteoarthritis in Benin. Afr J Disabil 2020; 9:675. [PMID: 33354532 PMCID: PMC7736690 DOI: 10.4102/ajod.v9i0.675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 08/27/2020] [Indexed: 11/23/2022] Open
Abstract
Background In Africa, primary hip osteoarthritis seems to be less frequent than in Europe. Sickle cell disease is responsible for aseptic osteonecrosis of the femoral head associated with secondary hip osteoarthritis. Very little evidence is available on the influence of aetiology (primary and secondary) and radiographic status on pain and disability in a Beninese population with hip osteoarthritis. Objectives The aim of this study was to compare the impacts of aetiology and radiographic status on pain, disability and quality of life in a Beninese population with hip osteoarthritis. Method This was a descriptive cross-sectional study, including participants recruited in the Clinic of Physical Medicine and Rehabilitation at the National Teaching Hospital in Cotonou. Assessment was based on the International Classification of Functioning, Disability and Health model. The main outcomes were severity of osteoarthritis, pain, range of motion, muscle strength, gait speed and quality of life. Statistical comparisons between the aetiologies were performed using a t-test or rank sum test. One-way analysis of variance was used to test the effect of radiographic status. Results Forty-nine participants (26 women and 23 men; mean age [standard deviation] 40.5 [17.9] years) were recruited. According to the aetiology (59.2% and 40.8% of primary and secondary osteoarthritis, respectively), there were no significant differences for any of the outcomes. Grades I, II, III and IV osteoarthritis were observed in 22.4%, 14.3%, 26.5% and 36.7% of the participants, respectively. Participants with grade IV osteoarthritis were more affected than those with grades I, II and III based on the Kellgren and Lawrence classification. Conclusion Aetiology did not influence pain, gait speed or quality of life. Participants with grade IV osteoarthritis had more pain, were more limited in walking and had a more impaired quality of life.
Collapse
Affiliation(s)
- Todègnon F Assogba
- Neuro Musculo Skeletal Lab (NMSK), Faculté des Sciences de la Motricité, Université Catholique de Louvain, Brussels, Belgium.,Clinique Universitaire de Médecine Physique et de Réadaptation, Centre National Hospitalier et Universitaire Hubert K. Maga, Cotonou, Benin
| | - Didier D Niama-Natta
- Clinique Universitaire de Médecine Physique et de Réadaptation, Centre National Hospitalier et Universitaire Hubert K. Maga, Cotonou, Benin
| | - Toussaint G Kpadonou
- Clinique Universitaire de Médecine Physique et de Réadaptation, Centre National Hospitalier et Universitaire Hubert K. Maga, Cotonou, Benin
| | - Teefany Lawson
- Clinique Universitaire de Médecine Physique et de Réadaptation, Centre National Hospitalier et Universitaire Hubert K. Maga, Cotonou, Benin
| | - Philippe Mahaudens
- Neuro Musculo Skeletal Lab (NMSK), Faculté des Sciences de la Motricité, Université Catholique de Louvain, Brussels, Belgium.,Service d'Orthopédie et de Traumatologie de l'Appareil Locomoteur, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Christine Detrembleur
- Neuro Musculo Skeletal Lab (NMSK), Faculté des Sciences de la Motricité, Université Catholique de Louvain, Brussels, Belgium
| |
Collapse
|
13
|
Ueoka K, Kabata T, Kajino Y, Inoue D, Ohmori T, Ueno T, Yoshitani J, Yamamuro Y, Tsuchiya H. Patient-reported outcomes following primary total hip arthroplasty in Crowe type III or IV developmental dysplasia are comparable to those in Crowe type I: a case-control study of 96 hips with intermediate-term follow-up. BMC Musculoskelet Disord 2020; 21:344. [PMID: 32493353 PMCID: PMC7271540 DOI: 10.1186/s12891-020-03371-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 05/27/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND A few previous studies have investigated patient satisfaction after total hip arthroplasty (THA) according to the degree of pelvic deformity. This study compared patient-reported outcomes after primary THA for Crowe types III, IV and I dysplasia. METHODS This retrospective, single-center, single-surgeon case-control study included patients who underwent primary THA between 2008 and 2016. We sent postal questionnaires to 38 patients with Crowe type III and IV dysplasia. Among the questionnaire respondents, 23 patients, excluding those with a follow-up period of < 1 year, were enrolled as the H group. The control group included 46 patients with Crowe type I, matched for sex, age, body mass index and surgical approach. To investigate the influence of femoral shortening osteotomy, the H group was divided according to whether femoral shortening osteotomy was performed. Ten patients underwent THA with femoral shortening osteotomy (FO group), while 12 patients underwent THA without femoral shortening osteotomy (N-FO group). Patient demographics, mean follow-up period, surgical information, pre- and postoperative leg length discrepancy (LLD), and perioperative complications were investigated. Clinical evaluations were performed using the Japanese Orthopaedic Association (JOA) scores, 36-item short-form survey (SF-36), net promotor score (NPS), visual analogue scale (VAS), and questionnaires. The VAS and SF-36 scores were determined only at final follow-up. RESULTS The H and control groups were not significantly different in the postoperative JOA scores and SF-36. In the H group, VAS at the final follow-up was significantly higher, and significantly more patients felt that postoperative rehabilitation was serious, expressing that they underwent THA for LLD correction. In addition, the VAS scores in the FO group was higher than those in the N-FO group. Postoperative LLD was significantly greater in the H group than in the control group. Each group had an NPS of > 50. CONCLUSION The postoperative VAS score was higher in Crowe type III and IV dysplasia than in Crowe type I dysplasia, but no significant differences were detected in the postoperative satisfaction, JOA score, and SF-36 score. These findings may help explain the effects of THA preoperatively to patients with Crowe type III and IV dysplasia. LEVEL OF EVIDENCE Therapeutic Level 3b.
Collapse
Affiliation(s)
- Ken Ueoka
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa City, Ishikawa Prefecture, 920-8641, Japan
| | - Tamon Kabata
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa City, Ishikawa Prefecture, 920-8641, Japan.
| | - Yoshitomo Kajino
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa City, Ishikawa Prefecture, 920-8641, Japan
| | - Daisuke Inoue
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa City, Ishikawa Prefecture, 920-8641, Japan
| | - Takaaki Ohmori
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa City, Ishikawa Prefecture, 920-8641, Japan
| | - Takuro Ueno
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa City, Ishikawa Prefecture, 920-8641, Japan
| | - Junya Yoshitani
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa City, Ishikawa Prefecture, 920-8641, Japan
| | - Yuki Yamamuro
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa City, Ishikawa Prefecture, 920-8641, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa City, Ishikawa Prefecture, 920-8641, Japan
| |
Collapse
|
14
|
Development of a knee joint assist suit with a velocity-based mechanical safety device: Control method and experiments. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2019.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
15
|
Maffiuletti NA, Item-Glatthorn JF, Friesenbichler B, Brioschi M, Muendle B, Ventura A, Stulz S, Leunig M, Casartelli NC. Hip muscle weakness in patients with hip osteoarthritis: Sex-specific differences and associations with hip morphology and symptoms. Joint Bone Spine 2019; 87:265-266. [PMID: 31568839 DOI: 10.1016/j.jbspin.2019.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/18/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Nicola A Maffiuletti
- Human Performance Lab, Schulthess Clinic, Lengghalde 2, 8008 Zurich, Switzerland
| | | | - Bernd Friesenbichler
- Human Performance Lab, Schulthess Clinic, Lengghalde 2, 8008 Zurich, Switzerland
| | - Marco Brioschi
- Department of Orthopedic Surgery and Traumatology, Niguarda Hospital, 20162 Milan, Italy
| | - Benedikt Muendle
- Human Performance Lab, Schulthess Clinic, Lengghalde 2, 8008 Zurich, Switzerland; Institute of Human Movement Sciences and Sport, ETH Zurich, 8057 Zurich, Switzerland
| | - Alessandra Ventura
- Human Performance Lab, Schulthess Clinic, Lengghalde 2, 8008 Zurich, Switzerland; Institute of Human Movement Sciences and Sport, ETH Zurich, 8057 Zurich, Switzerland
| | - Samara Stulz
- Human Performance Lab, Schulthess Clinic, Lengghalde 2, 8008 Zurich, Switzerland
| | - Michael Leunig
- Department of Orthopaedic Surgery, Schulthess Clinic, 8008 Zurich, Switzerland
| | - Nicola C Casartelli
- Human Performance Lab, Schulthess Clinic, Lengghalde 2, 8008 Zurich, Switzerland; Laboratory of Exercise and Health, ETH Zurich, 8603 Schwerzenbach, Switzerland.
| |
Collapse
|
16
|
Jerez-Mayorga D, Chirosa Ríos LJ, Reyes A, Delgado-Floody P, Machado Payer R, Guisado Requena IM. Muscle quality index and isometric strength in older adults with hip osteoarthritis. PeerJ 2019; 7:e7471. [PMID: 31410316 PMCID: PMC6689221 DOI: 10.7717/peerj.7471] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 07/15/2019] [Indexed: 12/16/2022] Open
Abstract
Background Older adults with hip osteoarthritis (OA) suffer a progressive loss of muscle quality and strength, affecting their daily activities and quality of life. The purpose of this study is to compare the levels of isometric strength among older adults with and without hip OA and healthy young adults, and to determine the relationship between muscle quality index (MQI) and isometric strength. Methods Fourteen subjects with hip OA (65.6 ± 3.0 years), 18 healthy older adults (66.6 ± 6.5 years) and 32 young adults (20.7 ± 2.0 years) participated in the study. MQI, isometric muscle strength of the hip, ten time sit-to-stand tests, and body composition were measured. Results The MQI was lower in subjects with hip OA, with no significant differences between groups (p > 0.054). Subjects with OA produced significantly less isometric strength in hip extension (p < 0.001), flexion (p < 0.001), abduction (p < 0.05), adduction (p < 0.001), external (p < 0.05) and internal rotation (p < 0.05). Subjects with OA demonstrated longer time in the execution of the sit-to-stand test (p < 0.001) in comparison with healthy older and young adults. High correlations between MQI, sit-to-stand (r = - 0.76, p < 0.01) and peak force during hip abduction (r = 0.78, p < 0.01) where found in subjects with OA. Moderate correlation between MQI and peak force during hip flexion (r = 0.55, p < 0.05) and external rotation (r = 0.61, p < 0.05) were found in the OA group. Conclusions Subjects with OA have lower MQI than old and young healthy controls. In subjects with OA, there was a significant relationship between isometric strength of hip muscles and performance on the sit-to-stand test and the MQI.
Collapse
Affiliation(s)
- Daniel Jerez-Mayorga
- Physical Education and Sports Department, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Luis Javier Chirosa Ríos
- Physical Education and Sports Department, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Alvaro Reyes
- Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Pedro Delgado-Floody
- Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Temuco, Chile
| | - Ramon Machado Payer
- Physical Education and Sports Department, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Isabel María Guisado Requena
- Nursing, Physiotherapy and Occupational Therapy Department, Faculty Nursing of Albacete, University of Castilla-La Mancha, Albacete, Spain
| |
Collapse
|
17
|
Freke MD, Crossley K, Sims K, Russell T, Weinrauch P, Gamboa G, Semciw A. Acute and Subacute Changes in Hip Strength and Range of Movement After Arthroscopy to Address Chondrolabral Pathology. Am J Sports Med 2019; 47:1939-1948. [PMID: 31157975 DOI: 10.1177/0363546519850816] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Hip pain is associated with reduced muscle strength, range of movement (ROM), and function. Hip arthroscopy is undertaken to address coexistent intra-articular pathologies with the aim of reducing pain and improving function. PURPOSE To evaluate changes in strength and ROM in a cohort with chondrolabral pathology before surgery to 3 and 6 months after hip arthroscopy. STUDY DESIGN Case series; Level of evidence, 4. METHODS Sixty-seven individuals with hip pain who were scheduled for hip arthroscopy were matched with 67 healthy controls. Hip strength and ROM were collected preoperatively and at 3 and 6 months postoperatively. Repeated measures analysis of variance evaluated whether strength and ROM differed between limbs and among time points. Bonferroni post hoc tests determined differences in hip strength and ROM among testing times and between the hip pain group and matched controls. RESULTS Hip extension, internal rotation (IR), external rotation (ER), and adduction (P < .040) strength were greater at 3 months after surgery; all directions, including flexion, abduction, and squeeze, were greater at 6 months (P < .015). Hip flexion ROM was greater at 3 months after surgery (P = .013). Flexion, IR, and ER ROM was greater at 6 months (P < .041). At 6 months, IR ROM (P = .003) and flexion, IR, and ER strength (P < .005) remained less than matched controls. CONCLUSION With the exception of squeeze and flexion, all directions of hip strength and hip flexion ROM are significantly improved 3 months after arthroscopy to address chondrolabral pathology. By 6 months after arthroscopy, strength in all directions and flexion and rotation ROM are significantly improved in both limbs, but hip flexion, IR, and ER strength and IR ROM remain significantly less than that of healthy matched controls in both limbs.
Collapse
Affiliation(s)
- Matthew D Freke
- Enoggera Health Centre, Gallipoli Barracks, Enoggera, Brisbane, Australia.,School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Brisbane, Australia
| | - Kay Crossley
- School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, Melbourne, Australia
| | - Kevin Sims
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Brisbane, Australia
| | - Trevor Russell
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Brisbane, Australia
| | | | - Gauguin Gamboa
- Brisbane Private Hospital, Spring Hill, Brisbane, Australia
| | - Adam Semciw
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Brisbane, Australia.,School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, Melbourne, Australia
| |
Collapse
|
18
|
Wörner T, Nilsson J, Thorborg K, Granlund V, Stålman A, Eek F. Hip Function 6 to 10 Months After Arthroscopic Surgery: A Cross-sectional Comparison of Subjective and Objective Hip Function, Including Performance-Based Measures, in Patients Versus Controls. Orthop J Sports Med 2019; 7:2325967119844821. [PMID: 31218235 PMCID: PMC6563410 DOI: 10.1177/2325967119844821] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background: Little is known about hip-related function, mobility, and performance in patients after hip arthroscopic surgery (HA) during the time that return to sports can be expected. Purpose: To evaluate measures of subjective and objective hip function 6 to 10 months after HA in patients compared with healthy controls and to compare objective function in the HA group between the operated and nonoperated hips. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 33 patients who had undergone HA (mean, 8.1 ± 2.6 months postoperatively) and 33 healthy participants matched on sex, age, and activity level were compared regarding subjective hip function (Copenhagen Hip and Groin Outcome Score [HAGOS]) and objective function including hip range of motion (ROM; flexion, internal rotation, and external rotation), isometric hip muscle strength (adduction, abduction, flexion, internal rotation, and external rotation), and performance-based measures: the Y Balance Test (YBT), medial and lateral triple-hop test, and Illinois agility test. Group differences were analyzed using independent-samples t tests. Paired-samples t tests were used for a comparison of the operated and nonoperated hips. Standard effect sizes (Cohen d) were provided for all outcomes. Results: The HA group reported worse subjective hip function than the control group (HAGOS subscores: d = –0.7 to –2.1; P ≤ .004). Objective measures of hip ROM (d = –0.5 to –1.1; P ≤ .048), hip flexion strength (d = –0.5; P = .043), and posteromedial reach of the YBT (d = –0.5; P = .043) were also reduced in the HA group, although there were no significant differences between groups regarding the remaining objective measures (d = –0.1 to –0.4; P ≥ .102 to .534). The only significant difference between the operated and nonoperated hips in the HA group was reduced passive hip flexion (d = –0.4; P = .045). Conclusion: Patients who had undergone HA demonstrated reduced subjective hip function compared with controls 6 to 10 months after surgery, when return to sports can be expected. While most objective strength and performance test results were comparable between the HA and control groups at 6 to 10 months after surgery, the HA group presented with impairments related to hip mobility and hip flexion strength. No consistent pattern of impairments was found in operated hips compared with nonoperated hips.
Collapse
Affiliation(s)
- Tobias Wörner
- Department of Health Sciences, Lund University, Lund, Sweden.,Capio Artro Clinic, Stockholm, Sweden
| | | | - Kristian Thorborg
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Department of Orthopaedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | | | - Anders Stålman
- Capio Artro Clinic, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Frida Eek
- Department of Health Sciences, Lund University, Lund, Sweden
| |
Collapse
|
19
|
Degeneration of the Sacroiliac Joint in Hip Osteoarthritis Patients: A Three-Dimensional Image Analysis. J Belg Soc Radiol 2019; 103:36. [PMID: 31149653 PMCID: PMC6534012 DOI: 10.5334/jbsr.1648] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective: The sacroiliac joint is an important source of low back pain and may be influenced by pathologies in adjoining structures such as the hip or the spine. This study aimed to investigate the influence of hip osteoarthritis on sacroiliac joint degeneration by examining the sacroiliac joints of hip osteoarthritis patients, focusing on the localization and quantity of vacuum phenomena. Materials and Methods: The preoperative computed tomography (CT) of 31 female hip replacement candidates (mean age 69.1) and pelvic CT of 34 age-matched controls (mean age 67.9) were used to reconstruct the sacroiliac joints three-dimensionally. The degeneration score of the sacroiliac joints on axial view, as well as the location and volume of vacuum phenomena in the three-dimensionally reconstructed sacroiliac joints, were analyzed. Results: The total sacroiliac joint degeneration scores were similar in hip osteoarthritis patients and controls but the breakdown of the score revealed that joint space narrowing and vacuum phenomena in the sacroiliac joint increase in hip osteoarthritis, while osteophytes decrease. Three-dimensional reconstruction revealed that the volume of vacuum phenomena in the sacroiliac joint was significantly larger in the hip osteoarthritis group and the vacuum areas were localized in the antero-superior region of the sacroiliac joint. Conclusion: Our results suggest that hip osteoarthritis and sacroiliac joint degeneration are related, and that with further investigation, the sacroiliac joint may become a new treatment target in hip osteoarthritis.
Collapse
|
20
|
Freke M, Kemp J, Crossley K, Sims K, Russell T, Semciw A. Strength and range of movement deficits are associated with symptom severity in people scheduled for hip arthroscopy. Eur J Pain 2019; 23:1083-1090. [PMID: 30746810 DOI: 10.1002/ejp.1371] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 11/09/2018] [Accepted: 01/20/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Identifying the physical impairments associated with worse symptoms and greater functional limitations in people with hip pain could enable targeted rehabilitation programmes designed to improve quality of life. The objective of this study was to compare physical characteristics between subgroups of symptoms and functional limitation severity in individuals with hip pain scheduled for arthroscopic surgery. METHODS Hip range of motion (ROM) and muscle strength were measured in 114 individuals (48 women; aged 32 ± 8 years) with hip pain scheduled for hip arthroscopy. Pain and disability were measured with the International Hip Outcome Tool (iHOT33) subscale of Symptoms and Functional Limitation, and a cluster analysis was used to identify mild, moderate and severe subgroups. Between-group differences were then evaluated using multivariate analysis of covariance, including sex as a covariate, followed by post hoc testing. Significance was set at 0.05. RESULTS Lesser hip muscle strength in all directions was reported in the severe symptoms and functional limitation group compared to the mild group. Hip flexion ROM differed when comparing the moderate to both the mild and severe subgroups. Hip internal rotation did not differ between subgroups of severity. CONCLUSIONS Individuals with hip pain and severe scores in the iHOT33 subscale of symptoms and functional limitations present with significantly lesser hip muscle strength and hip flexion ROM than individuals with moderate or mild scores. Targeted programmes to improve hip strength and flexion ROM in more severe patients may help reduce symptoms and improve function. SIGNIFICANCE Individuals with severe hip pain and functional limitation possess significantly lesser muscle strength and flexion ROM than individuals with moderate or mild scores.
Collapse
Affiliation(s)
- Matthew Freke
- Enoggera Health Centre, Gallipoli Barracks, Enoggera, Queensland, Australia.,School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Joanne Kemp
- School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Kay Crossley
- School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Kevin Sims
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Trevor Russell
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Adam Semciw
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia.,School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| |
Collapse
|
21
|
Retchford TH, Tucker KJ, Weinrauch P, Cowan SM, Grimaldi A, Kemp JL, Crossley KM. Clinical features of people with hip-related pain, but no clinical signs of femoroacetabular impingement syndrome. Phys Ther Sport 2018; 34:201-207. [PMID: 30388668 DOI: 10.1016/j.ptsp.2018.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/15/2018] [Accepted: 10/15/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Identifying impairments in hip range of motion (ROM) and muscle strength in people with hip-related pain, without signs of femoro-acetabular impingement syndrome (FAIS). STUDY AIMS to determine if hip strength and ROM i) differs between the symptomatic and less-symptomatic hip of people with hip-related pain; and between people with hip-related pain and healthy controls; and ii) are associated with hip-related Quality of Life and pain. DESIGN Cross-sectional study. SETTING University laboratory. PARTICIPANTS Thirty participants with hip-related pain who were awaiting hip arthroscopy (22 women; age = 37 ± 10yrs), 32 healthy controls (19 women; age = 30 ± 10yrs). MAIN OUTCOME MEASURES Hip ROM, muscle strength, pain intensity and the Hip disability and Osteoarthritis Outcome Score (HOOS) were assessed. RESULTS Less hip flexion ROM (p = 0.004), and extension (p = 0.004), abduction (p = 0.001) and internal rotation (IR) (p = 0.048) strength were measured on the symptomatic compared to non-symptomatic side. Hip-related pain participants had lower hip abduction strength (p = 0.045), and less flexion (p < 0.001), IR (p = 0.027) and external rotation (ER) (p = 0.019) ROM compared to controls. Less ER ROM (p = 0.03-0.04), and greater abduction (p = 0.03-0.04) and adduction strength (p = 0.02) were associated with better patient reported outcome measures. CONCLUSIONS Specific impairments in hip ROM and strength were identified in people with hip-related pain but no FAIS.
Collapse
Affiliation(s)
- Timothy H Retchford
- University of Queensland, St Lucia, Brisbane, Australia; Charles Sturt University, Albury, New South Wales, Australia.
| | - Kylie J Tucker
- University of Queensland, St Lucia, Brisbane, Australia.
| | - Patrick Weinrauch
- Wesley Hospital, Auchenflower, Brisbane, Australia; Brisbane Hip Clinic, Wickham Terrace, Spring Hill, Brisbane, Australia.
| | - Sallie M Cowan
- Clifton Hill Physiotherapy, Queens Parade, Clifton Hill, Melbourne, Australia; University of Melbourne, Parkville, Melbourne, Australia.
| | - Alison Grimaldi
- University of Queensland, St Lucia, Brisbane, Australia; Physiotec Physiotherapy, Brisbane, Queensland, Australia.
| | - Joanne L Kemp
- La Trobe University, Plenty Road, Melbourne, Australia.
| | | |
Collapse
|
22
|
Zacharias A, Green RA, Semciw A, English DJ, Kapakoulakis T, Pizzari T. Atrophy of hip abductor muscles is related to clinical severity in a hip osteoarthritis population. Clin Anat 2018; 31:507-513. [PMID: 29446121 DOI: 10.1002/ca.23064] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/06/2018] [Accepted: 02/13/2018] [Indexed: 11/08/2022]
Abstract
Osteoarthritis mainly affects weight-bearing joints such as the hip and knee and is the most common form of arthritis. Greater muscle atrophy with fatty infiltration of gluteal muscles and decreased hip abduction strength has previously been identified with increasing severity of radiological hip OA. However, it is well documented that radiographic findings of OA do not always correlate with clinical severity. The aim of this secondary analysis was to examine whether atrophy and strength of gluteus maximus (GMax), medius (GMed), minimus (GMin), and tensor fascia lata (TFL) is associated with the clinical severity of OA. Twenty participants with unilateral hip OA and 20 age- and sex-matched asymptomatic controls were classified on the basis of clinical severity (mild, moderate-severe and asymptomatic groups) using the Oxford hip score. Muscle volumes of GMax, GMed, GMin, and TFL were determined using magnetic resonance imaging and expressed as asymmetry between limbs. A hand-held dynamometer was used to identify hip rotation and abduction strength. Regression analyzes were used to identify the association between muscle asymmetry and patient-reported severity of hip OA. Both symptomatic groups (mild and moderate-severe) demonstrated significant asymmetry in GMax (P < 0.01) and GMin (P < 0.01). GMed asymmetry was associated with only the moderate-severe symptomatic group. Hip abduction strength was reduced in both symptomatic groups. Gluteal muscle atrophy was associated with the clinical severity of OA. Clinical severity could be a useful tool for clinicians interpreting likely gluteal muscle changes and planning rehabilitation strategies for hip OA patients. Clin. Anat. 31:507-513, 2018. © 2018 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Anita Zacharias
- Department of Pharmacy and Applied Science, College of Science, Health and Engineering, La Trobe University, Victoria.,Sport, Exercise and Rehabilitation Research Focus Area, La Trobe University, Victoria
| | - Rodney A Green
- Department of Pharmacy and Applied Science, College of Science, Health and Engineering, La Trobe University, Victoria.,Sport, Exercise and Rehabilitation Research Focus Area, La Trobe University, Victoria
| | - Adam Semciw
- La Trobe University Sports and Exercise Medicine Research Centre, Victoria.,School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Daniel J English
- Department of Pharmacy and Applied Science, College of Science, Health and Engineering, La Trobe University, Victoria.,Fusion Physiotherapy, Bendigo, Victoria, Australia
| | | | - Tania Pizzari
- Sport, Exercise and Rehabilitation Research Focus Area, La Trobe University, Victoria.,La Trobe University Sports and Exercise Medicine Research Centre, Victoria
| |
Collapse
|
23
|
The Assessment of Static Balance in Patients after Total Hip Replacement in the Period of 2-3 Years after Surgery. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3707254. [PMID: 29511678 PMCID: PMC5817328 DOI: 10.1155/2018/3707254] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 12/08/2017] [Accepted: 12/13/2017] [Indexed: 11/17/2022]
Abstract
Introduction The aim of this study was to assess static balance of patients after Total Hip Replacement (THR) compared with the age-matched, asymptomatic control group, considering the subject's gender and the time since the surgery. Materials and Methods The Total Hip Replacement (THR) group consisted of 55 subjects (mean age: 56.3 ± 8.7 years) and the control group consisted of 48 subjects (mean age: 58 ± 6.2 years). For the assessment of static balance, a stabilometric force platform was used. All subjects performed two 30-second trials in the double-leg stance position with eyes opened and closed. In the study group, the stabilometric assessment was performed once within the period of 24 to 36 months after the surgery. Results Subjects from the study group had significantly increased mediolateral COP velocity in the test with eyes opened, as well as the values of most of the COP parameters (excluding COP path area) in the test with eyes closed, compared to the control group. Higher values of the selected COP parameters were observed in the male subjects from the study group. Conclusion In contrast to a number of papers, our study revealed some deficits in static balance in patients after THR up to 2-3 years after surgery.
Collapse
|
24
|
Tsai J, Pedowitz DI. Next-Generation, Minimal-Resection, Fixed-Bearing Total Ankle Replacement: Indications and Outcomes. Clin Podiatr Med Surg 2018; 35:77-83. [PMID: 29156169 DOI: 10.1016/j.cpm.2017.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Total ankle arthroplasty is an increasingly popular procedure to address tibiotalar joint arthritis. Implant design and the rationale behind it have changed throughout the years. Newer generation implants allow for minimal resection of bone and use fixed-bearing technology. Long-term follow-up multicenter studies will determine the lifetime of these devices and their effectiveness in addressing pain and improving function for patients with endstage tibiotalar arthritis.
Collapse
Affiliation(s)
- Justin Tsai
- Department of Orthopaedic Surgery, SUNY Downstate College of Medicine, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - David I Pedowitz
- The Rothman Institute, 925 Chestnut Street, Philadelphia, PA 19107, USA.
| |
Collapse
|
25
|
Murata S, Doi T, Sawa R, Saito T, Nakamura R, Isa T, Ebina A, Kondo Y, Tsuboi Y, Misu S, Ono R. Association between joint stiffness and health-related quality of life in community-dwelling older adults. Arch Gerontol Geriatr 2017; 73:234-239. [DOI: 10.1016/j.archger.2017.07.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 07/18/2017] [Accepted: 07/22/2017] [Indexed: 11/30/2022]
|
26
|
Does decrease in hip range of motion interfere in frontal plane leg alignment in teenage soccer players? EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2017; 28:477-483. [PMID: 29080049 DOI: 10.1007/s00590-017-2066-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 10/04/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION This study determines cross-sectional changes in transverse plane hip range of motion (ROM) in teenager soccer athletes and non-athletes and correlates these measures with changes in frontal plane leg alignment (varus-valgus alignment). EVIDENCE ACQUISITION This was a comparative cross-sectional study with non-random convenience sampling. EVIDENCE SYNTHESIS Participants were recruited from a major professional soccer club and two local state-run schools in southern Brazil. A total of 396 male participants aged 9-18 years were assessed, 183 soccer players (athlete group; mean age, 13.3 ± 2.7 years) and 213 students (non-athlete group; mean age 14.4 ± 2.5 years). Hip internal rotation (IR) and external rotation (ER) and frontal plane leg alignment were measured in all participants. Changes in transverse plane hip ROM and frontal plane leg alignment were determined. Mean IR was 20.7° ± 5.8° in athletes versus 32.8° ± 2.9° in non-athletes, and mean ER was 36.5° ± 7.4° in athletes versus 46.7° ± 4.8° in non-athletes. Overall, IR was decreased in the athlete group compared to the non-athlete group (P < 0.001). Mean IR and ER were significantly lower in older athletes (P < 0.001), while only ER was significantly lower in older non-athletes (P < 0.001). Varus leg alignment was prevalent at all ages in the athlete group (71.0%, P = 0.153). In the non-athlete group, the occurrence of varus leg alignment was higher in older participants (P = 0.001). Lower mean IR was correlated with more severe varus leg alignment in the athlete group (rs = 0.19; P = 0.009). CONCLUSIONS We found a lower hip ROM, particularly in IR, in teenager soccer players according to the enhancement age group from the sample. But varus alignment of the leg was also prevalent in this group and comes before hip abnormalities started to be detected.
Collapse
|
27
|
Bieler T, Siersma V, Magnusson SP, Kjaer M, Beyer N. Exercise induced effects on muscle function and range of motion in patients with hip osteoarthritis. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2017; 23. [DOI: 10.1002/pri.1697] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/14/2017] [Accepted: 09/08/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Theresa Bieler
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg Hospital; University of Copenhagen; Copenhagen Denmark
- Institute of Sports Medicine Copenhagen, Bispebjerg and Frederiksberg Hospital; University of Copenhagen and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen; Copenhagen Denmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health; University of Copenhagen; Copenhagen Denmark
| | - S. Peter Magnusson
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg Hospital; University of Copenhagen; Copenhagen Denmark
- Institute of Sports Medicine Copenhagen, Bispebjerg and Frederiksberg Hospital; University of Copenhagen and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen; Copenhagen Denmark
| | - Michael Kjaer
- Institute of Sports Medicine Copenhagen, Bispebjerg and Frederiksberg Hospital; University of Copenhagen and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen; Copenhagen Denmark
| | - Nina Beyer
- Department of Physical and Occupational Therapy, Bispebjerg and Frederiksberg Hospital; University of Copenhagen; Copenhagen Denmark
- Institute for Clinical Medicine; University of Copenhagen; Copenhagen Denmark
| |
Collapse
|
28
|
Bream E, Black N. What is the Relationship Between Patients’ And Clinicians’ Reports of the Outcomes of Elective Surgery? J Health Serv Res Policy 2017; 14:174-82. [DOI: 10.1258/jhsrp.2009.008115] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objectives To identify studies in which patients’ and clinicians’ reports of health status and complications of one of four elective operations - hip and knee replacement, varicose vein surgery and groin hernia repair - are reported, and to describe the associations that have been reported between clinicians’ and patients’ reports. Methods Systematic search of several bibliographic databases and review of citations of articles meeting inclusion criteria. A narrative summary of the findings was conducted. Results Most of the 62 studies of health status identified were for hip (23) or knee (33) disease. The literature on complications was even more limited with 12 studies of surgical site infection, one for urinary tract infection and none for lower respiratory tract infections. Procedure-specific complications were restricted to one for arthroplasties and three for hernia repair. Despite considerable variation in the findings of studies, some clear patterns emerge, albeit they are largely based on arthroplasty. Patients’ and clinicians’ views of health status generally correlate moderately (0.5-0.6) when both are reporting on the same dimension of health status. Inevitably this is confined to disability, though patients’ and clinicians’ reports of symptoms are also moderately correlated. In contrast, comparisons of different dimensions, such as patients’ reports of disability and clinicians’ reports of impairment, result in poor correlation (0.3). There is huge variation in the way postoperative complications are measured which limits the extent to which an overview can be undertaken. Despite that, moderate to strong correlations have been reported between patients’ and clinicians’ views of complications. Conclusions Patients’ views of their level of disability reflect clinicians’ views and can be relied upon to assess this dimension of health status. In addition, patients are the ‘gold standard’ judges of symptoms and quality of life. Given these findings, clinicians, provider managers, commissioners and politicians can be confident that patients’ reports provide an accurate indication of the outcome of elective surgery.
Collapse
Affiliation(s)
| | - Nick Black
- Health Services Research Unit, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
29
|
Amano T, Hasegawa Y, Seki T, Takegami Y, Murotani K, Ishiguro N. A pre-operative predictive score for the outcome of eccentric rotational acetabular osteotomy in the treatment of acetabular dysplasia and early osteoarthritis of the hip in adults. Bone Joint J 2017; 98-B:1326-1332. [PMID: 27694585 DOI: 10.1302/0301-620x.98b10.37515] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 06/30/2016] [Indexed: 11/05/2022]
Abstract
AIMS The influence of identifiable pre-operative factors on the outcome of eccentric rotational acetabular osteotomy (ERAO) is unknown. We aimed to determine the factors that might influence the outcome, in order to develop a scoring system for predicting the prognosis for patients undergoing this procedure. PATIENTS AND METHODS We reviewed 700 consecutive ERAOs in 54 men and 646 women with symptomatic acetabular dysplasia or early onset osteoarthritis (OA) of the hip, which were undertaken between September 1989 and March 2013. The patients' pre-operative background, clinical and radiological findings were examined retrospectively. Multivariate Cox regression analysis was performed using the time from the day of surgery to a conversion to total hip arthroplasty (THA) as an endpoint. A risk score was calculated to predict the prognosis for conversion to THA, and its predictive capacity was investigated. RESULTS The congruity of the hip, age, the pre-operative minimum width of the joint space and range of abduction were identified as factors predicting conversion to THA. For three groups of patients (scoring 0 to 5, 6 to 7, and 8 to 9 points), the Kaplan-Meier event-free rates of survival at 15 years post-operatively for conversion to THA were 99.6%, 85.2% and 67.3%, respectively. CONCLUSION These four pre-operative factors are easily measured and predict the prognosis for patients following ERAO. They may be used for decision making when offering surgical treatment to patients with acetabular dysplasia and early onset osteoarthritis. Cite this article: Bone Joint J 2016;98-B:1326-32.
Collapse
Affiliation(s)
- T Amano
- Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Y Hasegawa
- Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - T Seki
- Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Y Takegami
- Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - K Murotani
- Aichi Medical University, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan
| | - N Ishiguro
- Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| |
Collapse
|
30
|
Kemp JL, Makdissi M, Schache AG, Finch CF, Pritchard MG, Crossley KM. Is quality of life following hip arthroscopy in patients with chondrolabral pathology associated with impairments in hip strength or range of motion? Knee Surg Sports Traumatol Arthrosc 2016; 24:3955-3961. [PMID: 26138455 DOI: 10.1007/s00167-015-3679-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 06/15/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION If physical impairments that are associated with poorer outcomes can be identified in people with chondrolabral hip pathology, then rehabilitation programmes that target such modifiable impairments could potentially be established to improve quality of life. The aim of this study was to examine the relationship between quality-of-life PROs and physical impairment measurements in people with chondrolabral pathology post-hip arthroscopic surgery. METHODS This was a cross-sectional study where multiple stepwise linear regression analyses were conducted to determine which physical impairment measurements were most associated with poorer quality-of-life patient-reported outcomes (PROs). Eighty-four patients (42 women; all aged 36 ± 10 years) with hip chondrolabral pathology 12- to 24-month post-hip arthroscopy were included. The Hip disability and Osteoarthritis Outcome Score Quality-of-life (HOOS-Q) subscale and International Hip Outcome Tool (IHOT-33) PROs were collected. Measurements of active hip ROM and strength were assessed. RESULTS Modifiable post-surgical physical impairments were associated with PRO in patients with chondrolabral pathology. Greater hip flexion ROM was independently associated with better scores in both HOOS-Q and IHOT-33 (adjusted r 2 values ranged from 0.249 to 0.341). Greater hip adduction strength was independently associated with better HOOS-Q and IHOT-33 (adjusted r 2 0.227-0.317). Receiver Operator Curve analyses determined that the limit value for hip flexion ROM was 100° (sensitivity 92 %, specificity 75 %), and hip adduction strength was 0.86 Nm/kg (sensitivity 96 %, specificity 70 %). CONCLUSIONS Hip flexion ROM and adduction strength were associated with better quality-of-life PRO scores in patients with chondrolabral pathology 12- to 24-month post-hip arthroscopy. These impairments could be targeted by clinicians designing rehabilitation programmes to this patient group. LEVEL OF EVIDENCE Cross-sectional study, Level IV.
Collapse
Affiliation(s)
- Joanne L Kemp
- Australian Centre for Research into Injury and Sport and its Prevention (ACRISP), Federation University Australia, SMB Campus, PO Box 663, Ballarat, VIC, 3353, Australia.
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.
| | - Michael Makdissi
- Centre for Health, Exercise and Sports Medicine (CHESM), University of Melbourne, Parkville, Australia
| | - Anthony G Schache
- Melbourne School of Engineering, University of Melbourne, Parkville, Australia
| | - Caroline F Finch
- Australian Centre for Research into Injury and Sport and its Prevention (ACRISP), Federation University Australia, SMB Campus, PO Box 663, Ballarat, VIC, 3353, Australia
| | | | - Kay M Crossley
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| |
Collapse
|
31
|
Factors associated with restricted hip extension during gait in women after total hip arthroplasty. Hip Int 2016; 25:543-8. [PMID: 26351118 DOI: 10.5301/hipint.5000286] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/05/2015] [Indexed: 02/04/2023]
Abstract
PURPOSE A decreased peak hip extension angle in the late stance phase is a major gait abnormality in patients with THA. The purpose of this study was to determine the relationship between peak hip extension angle during gait and functional impairments such as muscle weakness and the limitation in joint range of motion and to identify the clinical factors influencing peak hip extension angle during gait. METHODS 67 female volunteers with THA were examined. Biomechanical gait analysis was performed to measure peak hip extension angle during gait. Maximal isometric strength of the hip and knee, passive hip extension range of motion, leg length discrepancy, and hip pain were assessed. RESULTS Peak hip extension angle during gait significantly correlated with passive hip extension range of motion (r = 0.259), hip pain (r = -0.264), isometric strengths of the hip musculature (r = 0.278-0.491), and knee extensor (r = 0.386). Stepwise multiple regression analysis revealed that hip abductor torque (β = 0.355, P = 0.001), hip pain (β = -0.353, P = 0.001), and passive hip extension range of motion (β = 0.258, P = 0.011) were significant contributors to peak hip extension angle during gait (R2 = 0.408). CONCLUSIONS Our findings suggest that THA rehabilitation aimed at improving gait ability should focus on strengthening the hip abductors, controlling hip pain and increasing range of motion of hip extension.
Collapse
|
32
|
Østerås H, Paulsberg F, Olsen SE, Østerås B, Torstensen TA. Effects of medical exercise therapy in patients with hip osteoarthritis: A randomized controlled trial with six months follow-up. A pilot study. J Bodyw Mov Ther 2016; 21:284-289. [PMID: 28532870 DOI: 10.1016/j.jbmt.2016.06.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 06/24/2016] [Accepted: 06/28/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND & AIMS There is no consensus regarding what type of exercises, combination of exercises or exercise dosage is most effective in patients with long-term hip arthrosis. The goal of this study was to evaluate the effects of two different exercise programs related to dose-response relationships. METHOD Prospective randomized controlled clinical trial with 6 months follow where 33 participants were randomly assigned to either high repetitive, high dosage medical exercise therapy (MET) (n = 16) or low dosage exercise therapy (ET) (n = 17). Primary outcomes are pain using a visual analog scale (VAS) and function using a functional assessment questionnaire (WOMAC). RESULTS Patients were equal at baseline. Two patients (6%) dropped out during the treatment period. There were no difference between groups after end of treatment nor at 6 months follow up. However, there were significant differences within each exercise group at end of treatment. CONCLUSION In this pilot study, we were not able to show any difference between MET and ET. More research is needed with a larger patient population and a more extensive exercise period similar to other studies that are published regarding dose-response effects. Clinicaltrials.gov identifier: NCT01700933.
Collapse
Affiliation(s)
- Håvard Østerås
- Norwegian University of Science and Technology, Faculty of Health and Social Science, Trondheim, Norway.
| | | | | | - Berit Østerås
- Norwegian University of Science and Technology, Faculty of Health and Social Science, Trondheim, Norway
| | - Tom Arild Torstensen
- Holten Institute, Stockholm, Sweden and NVS Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
33
|
Long-Term Effect of Exercise Therapy and Patient Education on Impairments and Activity Limitations in People With Hip Osteoarthritis: Secondary Outcome Analysis of a Randomized Clinical Trial. Phys Ther 2016; 96:818-27. [PMID: 26678445 DOI: 10.2522/ptj.20140520] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 12/06/2015] [Indexed: 02/09/2023]
Abstract
BACKGROUND The effect of exercise on specific impairments and activity limitations in people with hip osteoarthritis (OA) is limited. OBJECTIVE The study objective was to evaluate the long-term effect of exercise therapy and patient education on range of motion (ROM), muscle strength, physical fitness, walking capacity, and pain during walking in people with hip OA. DESIGN This was a secondary outcome analysis of a randomized clinical trial. SETTING The setting was a university hospital. PARTICIPANTS One hundred nine people with clinically and radiographically evident hip OA were randomly allocated to receive both exercise therapy and patient education (exercise group) or patient education only (control group). INTERVENTION All participants attended a patient education program consisting of 3 group meetings led by 2 physical therapists. Two other physical therapists were responsible for providing the exercise therapy program, consisting of 2 or 3 weekly sessions of strengthening, functional, and stretching exercises over 12 weeks. Both interventions were conducted at a sports medicine clinic. MEASUREMENTS Outcome measures included ROM, isokinetic muscle strength, predicted maximal oxygen consumption determined with the Astrand bicycle ergometer test, and distance and pain during the Six-Minute Walk Test (6MWT). Follow-up assessments were conducted 4, 10, and 29 months after enrollment by 5 physical therapists who were unaware of group allocations. RESULTS No significant group differences were found for ROM, muscle strength, predicted maximal oxygen consumption, or distance during the 6MWT over the follow-up period, but the exercise group had less pain during the 6MWT than the control group at 10 months (mean difference=-8.5 mm; 95% confidence interval=-16.1, -0.9) and 29 months (mean difference=-9.3 mm; 95% confidence interval=-18.1, -0.6). LIMITATIONS Limitations of the study were reduced statistical power and 53% rate of adherence to the exercise therapy program. CONCLUSIONS The previously described effect of exercise on self-reported function was not reflected by beneficial results for ROM, muscle strength, physical fitness, and walking capacity, but exercise in addition to patient education resulted in less pain during walking in the long term.
Collapse
|
34
|
Amano T, Hasegawa Y, Seki T, Takegami Y, Murotani K, Ishiguro N. Preoperative prognosis score is a useful tool regarding eccentric rotational acetabular osteotomy in patients with acetabular dysplasia. J Orthop Sci 2016; 21:348-53. [PMID: 27012377 DOI: 10.1016/j.jos.2016.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/16/2016] [Accepted: 02/22/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND It is unknown how possible preoperative factors influence the postoperative outcome of eccentric rotational acetabular osteotomy (ERAO). We aimed to determine these factors and to develop a scoring system for predicting the prognosis after ERAO in patients with symptomatic hip dysplasia. PATIENTS We included 700 patients (54 men, 646 women) who underwent ERAO during September 1989 to March 2013. The patients' clinical background, preoperative clinical findings, and preoperative imaging findings were examined retrospectively. Univariate and multivariate Cox regression were performed using the time from the day of surgery to a Harris hip score (HHS) <80 as an endpoint. A failure score was defined to predict the prognosis for an HHS <80, and its predictive capacity was assessed. RESULTS Ninety patients had an HHS <80. Forty-two patients underwent conversion to total hip arthroplasty (THA) after their HHS decreased to <80. Five factors were identified in relation to an HHS <80: a history of congenital dislocation of the hip, joint congruity, body mass index, the preoperative minimum joint space width, and the preoperative abduction range of motion. We estimated the weight of each factor using the results of multivariate Cox regression, and the outcome prediction scoring was obtained (0-17 points). For three groups of patients (total points of each factors: 0-5, 6-9, and ≥10 points), the Kaplan-Meier event-free survival rates at 15 years postoperatively for an HHS <80 were 97%, 81%, and 55%, respectively; the survival rates for THA conversion using this prediction scoring were 99%, 96%, and 85%, respectively. CONCLUSIONS Five preoperative factors can easily and clearly predict the prognosis following ERAO. The prognosis score may be a useful tool when making a decision regarding operative treatments in adult patients with acetabular dysplasia.
Collapse
Affiliation(s)
- Takafumi Amano
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Japan.
| | - Yukiharu Hasegawa
- Department of Hip and Knee Reconstructive Surgery, Nagoya University Graduate School of Medicine, Japan
| | - Taisuke Seki
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Japan
| | - Yasuhiko Takegami
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Japan
| | - Kenta Murotani
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Japan
| | - Naoki Ishiguro
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Japan; Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Japan
| |
Collapse
|
35
|
Hara D, Nakashima Y, Hamai S, Higaki H, Ikebe S, Shimoto T, Yoshimoto K, Iwamoto Y. Dynamic hip kinematics in patients with hip osteoarthritis during weight-bearing activities. Clin Biomech (Bristol, Avon) 2016; 32:150-6. [PMID: 26687769 DOI: 10.1016/j.clinbiomech.2015.11.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 11/26/2015] [Accepted: 11/26/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND There is an interest in quantifying the hip kinematics of patients with end-stage hip disorders before total hip arthroplasty. The purpose of the present study was to obtain dynamic hip kinematics under four different conditions, including deep flexion and rotation, in patients with osteoarthritis of the hip. METHODS Continuous X-ray images were obtained in 14 patients during gait, chair-rising, squatting, and twisting, using a flat panel X-ray detector. These patients received computed tomography scan to generate virtual digitally reconstructed radiographs. The density-based digitally reconstructed radiographs were then compared with the serial X-ray images acquired using image correlations. These 3D-to-2D model-to-image registration techniques determined the 3D positions and orientations of the pelvis and femur during the movement cycle of each activity. FINDINGS For gait, chair-rising, and squatting, the maximum hip flexion angles averaged 22°, 64°, and 68°, respectively. The pelvis was tilted anteriorly by an average of around 7° during the full gait cycle. For chair-rising and squatting, the maximum absolute values of anterior/posterior pelvic tilt averaged 8°/17° and 6°/18°, respectively. Hip flexion showed maximum flexion angle on the way of movement due to further anterior pelvic tilt during both chair-rising and squatting. For twisting, the maximum absolute values of internal/external hip rotation averaged 3°/13°. INTERPRETATION Patients with hip osteoarthritis prior to total hip arthroplasty demonstrated the limited ranges of coordinated motion of the pelvis, femur, and hip joint during each activity, especially in deeply flexed and rotated postures.
Collapse
Affiliation(s)
- Daisuke Hara
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Satoshi Hamai
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Hidehiko Higaki
- Department of Biorobotics, Faculty of Engineering, Kyushu Sangyo University, 2-3-1 Matsugadai, Higashi-ku, Fukuoka 813-0004, Japan.
| | - Satoru Ikebe
- Department of Biorobotics, Faculty of Engineering, Kyushu Sangyo University, 2-3-1 Matsugadai, Higashi-ku, Fukuoka 813-0004, Japan.
| | - Takeshi Shimoto
- Department of Information and Systems Engineering, Faculty of Information Engineering, Fukuoka Institute of Technology, 3-30-1 Wajiro-higashi, Higashi-ku, Fukuoka 811-0295, Japan.
| | - Kensei Yoshimoto
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Yukihide Iwamoto
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| |
Collapse
|
36
|
Couraud G, Escalas C, Etcheto A, Rannou F, Poiraudeau S. French adaptation and validation of the Osteoarthritis Quality of Life scale. Ann Phys Rehabil Med 2015; 58:336-42. [PMID: 26596580 DOI: 10.1016/j.rehab.2015.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 09/06/2015] [Accepted: 09/27/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The Osteoarthritis Quality of Life scale (OAQoL) is an osteoarthritis-specific measure developed in the United Kingdom by a needs-based approach. This study describes the adaptation and validation of this English scale into French. METHODS The OAQoL was translated into French by a dual-panel technique followed by cognitive debriefing interviews. Internal consistency was assessed by the Cronbach α. Construct validity was tested by exploratory and confirmatory factor analyses and by convergent and divergent correlations with other patient-reported outcome measures by the Spearman rho (ρ). Reliability was explored by Spearman rho as well as the Bland and Altman method for the total score and Cohen's kappa for each item score. RESULTS Cognitive debriefing revealed the French OAQoL to be clear, relevant and comprehensive. The Cronbach α was 0.91. Exploratory factor analysis extracted 4 groups of items. After eliminating 4 items, confirmatory factor analysis of the remaining 18 items confirmed higher intra-factor than inter-factor correlations. The expected convergent and divergent correlations were observed. Test-retest reliability was good (ρ 0.93) and was confirmed by Bland and Altman analysis; most items (12/18) had kappa values from 0.61 to 0.80. CONCLUSION The French OAQoL is an easy-to-use 18-item questionnaire with good content and construct validity to assess the impact of osteoarthritis on quality of life for French-speaking patients.
Collapse
Affiliation(s)
- G Couraud
- Inserm U1153, université Paris Descartes, hôpital Cochin, AP-HP, 75619 Paris, France.
| | - C Escalas
- Inserm U1153, université Paris Descartes, hôpital Cochin, AP-HP, 75619 Paris, France
| | - A Etcheto
- Inserm U1153, université Paris Descartes, hôpital Cochin, AP-HP, 75619 Paris, France
| | - F Rannou
- Inserm U1153, université Paris Descartes, hôpital Cochin, AP-HP, 75619 Paris, France
| | - S Poiraudeau
- Inserm U1153, université Paris Descartes, hôpital Cochin, AP-HP, 75619 Paris, France.
| |
Collapse
|
37
|
Wei XZ, Xu XM, Wang F, Li M, Wang ZM. Radiological Assessment of the Sacrofemoral Angle: A Novel Method to Measure the Range of Hip Joint Flexion. Chin Med J (Engl) 2015; 128:2318-21. [PMID: 26315079 PMCID: PMC4733802 DOI: 10.4103/0366-6999.163380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND A quantitative and accurate measurement of the range of hip joint flexion (RHF) is necessarily required in the evaluation of disordered or artificial hip joint function. This study aimed to assess a novel method to measure RHF more accurately and objectively. METHODS Lateral radiographs were taken of 31 supine men with hip joints extended or flexed. Relevant angles were measured directly from the radiographs. The change in the sacrofemoral angle (SFA) (the angle formed between the axis of the femur and the line tangent to the upper endplate of S1) from hip joint extension to hip joint flexion, was proposed as the RHF. The validity of this method was assessed via concomitant measurements of changes in the femur-horizontal angle (between the axis of the femur and the horizontal line) and the sacrum-horizontal angle (SHA) (between the line tangent to the upper endplate of S1 and the horizontal line), the difference of which should equal the change in the SFA. RESULTS The mean change in the SFA was 112.5 ± 7.4°, and was independent of participant age, height, weight, or body mass index. The mean changes in the femur-horizontal and SHAs were 123.0 ± 6.4° and 11.4 ± 3.0°, respectively. This confirmed that the change of SFA between hip joint extension and hip joint flexion was equal to the difference between the changes in the femur-horizontal and SHAs. CONCLUSIONS Using the SFA, to evaluate RHF could prevent compromised measurements due to the movements of pelvis and lumbar spine during hip flexion, and is, therefore, a more accurate and objective method with reasonable reliability and validity.
Collapse
Affiliation(s)
| | | | | | | | - Zi-Min Wang
- Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
| |
Collapse
|
38
|
Steinhilber B, Haupt G, Miller R, Grau S, Janssen P, Krauss I. Stiffness, pain, and hip muscle strength are factors associated with self-reported physical disability in hip osteoarthritis. J Geriatr Phys Ther 2015; 37:99-105. [PMID: 24406707 DOI: 10.1519/jpt.0b013e3182abe7b5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Physical disability (PD) is common among patients with osteoarthritis (OA) of the hip. Exercise therapy is proposed to be a potential intervention to reduce PD. However, the optimal targets of an exercise program are not known. PURPOSE The aim of the present study was to identify factors that explain the level of self-reported PD in patients with hip OA. Knowledge of these factors will help develop specific and effective exercise programs. METHODS Data from 149 patients with hip OA (85 men and 64 women) were analyzed. Self-reported PD was quantified using the physical function subscale of the Western Ontario and McMaster index. A stepwise regression analysis was conducted to identify significant factors associated with self-reported PD. RESULTS Stiffness, pain, and hip muscle strength were found to be significant factors related to the level of self-reported PD in hip OA. These factors explained 59% (r adjusted = 0.59) of the variance. Body mass index, gender, age, and passive internal hip rotation and flexion range of motion explained only minor parts of the dependent variable self-reported PD. DISCUSSION AND CONCLUSION Stiffness, pain, and hip muscle strength are associated with self-reported PD in hip OA. It is imperative that exercise treatments for hip OA include strategies to modify these factors. Further research should evaluate their role in preventing hip OA.
Collapse
Affiliation(s)
- Benjamin Steinhilber
- 1Medical Clinic, Department of Sports Medicine, University of Tübingen, Tuebingen, Germany. 2University of Gothenburg, Department of Food and Nutrition, and Sport Science Biomechanics, Göteborg, Schweden
| | | | | | | | | | | |
Collapse
|
39
|
Unipedal balance is affected by lower extremity joint arthroplasty procedure 1 year following surgery. J Arthroplasty 2015; 30:286-9. [PMID: 25257235 DOI: 10.1016/j.arth.2014.08.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 08/07/2014] [Accepted: 08/23/2014] [Indexed: 02/01/2023] Open
Abstract
Lower Extremity Joint Arthroplasty (LEJA) surgery is an effective way to alleviate painful osteoarthritis. Unfortunately, these surgeries do not normalize the loading asymmetry during the single leg stance phase of gait. Therefore, we examined single leg balance in 234 TJA patients (75 hips, 65 knees, 94 ankles) approximately 12 months following surgery. Patients passed if they maintained single leg balance for 10s with their eyes open. Patients one year following total hip arthroplasty (THA-63%) and total knee arthroplasty (TKA-69%) had similar pass rates compared to a total ankle arthroplasty (TAA-9%). Patients following THA and TKA exhibit better unilateral balance in comparison with TAA patients. It may be beneficial to include a rigorous proprioception and balance training program in TAA patients to optimize functional outcomes.
Collapse
|
40
|
Mikkelsen LR, Mechlenburg I, Søballe K, Jørgensen LB, Mikkelsen S, Bandholm T, Petersen AK. Effect of early supervised progressive resistance training compared to unsupervised home-based exercise after fast-track total hip replacement applied to patients with preoperative functional limitations. A single-blinded randomised controlled trial. Osteoarthritis Cartilage 2014; 22:2051-8. [PMID: 25305374 DOI: 10.1016/j.joca.2014.09.025] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 08/26/2014] [Accepted: 09/30/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine if 2 weekly sessions of supervised progressive resistance training (PRT) in combination with 5 weekly sessions of unsupervised home-based exercise is more effective than 7 weekly sessions of unsupervised home-based exercise in improving leg-extension power of the operated leg 10 weeks after total hip replacement (THR) in patients with lower pre-operative function. METHOD A total of 73 patients scheduled for THR were randomised (1:1) to intervention group (IG, home based exercise 5 days/week and PRT 2 days/week) or control group (CG, home based exercise 7 days/week). The primary endpoint was change in leg extension power at 10 week follow up. Secondary outcomes were isometric hip muscle strength, sit-to-stand test, stair climb test, 20 m walking speed and patient-reported outcome (HOOS). RESULTS Sixty-two completed the trial (85%). Leg extension power increased from baseline to the 10 week follow up in both groups; mean [95% CI] IG: 0.29 [0.13; 0.45] and CG: 0.26 [0.10; 0.42] W/kg, with no between-group difference (primary outcome) (P = 0.79). Maximal walking speed (P = 0.008) and stair climb performance (P = 0.04) improved more in the IG compared to CG, no other between-group differences existed. CONCLUSIONS In this trial, supervised PRT twice a week in addition to 5 weekly sessions of unsupervised exercise for 10 weeks was not superior to 7 weekly sessions of unsupervised home-based exercise for 10 weeks in improving the primary outcome, leg-extension power of the operated leg, at the primary endpoint 10 weeks after surgery in THR patients with lower pre-operative function. TRIAL REGISTRATION NCT01214954.
Collapse
Affiliation(s)
- L R Mikkelsen
- Interdisciplinary Research Unit, Elective Surgery Centre, Silkeborg Regional Hospital, Denmark; Lundbeck Centre for Fast-track Hip and Knee Arthroplasty, Denmark.
| | - I Mechlenburg
- Department of Orthopaedic Surgery, Aarhus University Hospital, Denmark.
| | - K Søballe
- Department of Orthopaedic Surgery, Aarhus University Hospital, Denmark.
| | - L B Jørgensen
- Interdisciplinary Research Unit, Elective Surgery Centre, Silkeborg Regional Hospital, Denmark; Institute of Clinical Medicine, Aarhus University, Denmark.
| | - S Mikkelsen
- Interdisciplinary Research Unit, Elective Surgery Centre, Silkeborg Regional Hospital, Denmark.
| | - T Bandholm
- Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Department of Physiotherapy, Copenhagen University Hospital, Hvidovre, Denmark; Department of Orthopaedic Surgery and Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark.
| | - A K Petersen
- Department of Physiotherapy- and Occupational Therapy, Aarhus University Hospital, Denmark; Centre of Research in Rehabilitation (CORIR), Institute of Clinical Medicine, Aarhus University, Denmark.
| |
Collapse
|
41
|
Mikkelsen LR, Mikkelsen S, Søballe K, Mechlenburg I, Petersen AK. A study of the inter-rater reliability of a test battery for use in patients after total hip replacement. Clin Rehabil 2014; 29:165-74. [DOI: 10.1177/0269215514534088] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Objective: To assess the within-day inter-rater reliability of a test battery of functional performance, muscle strength and leg extension power on total hip replacement patients. Design: A test–retest design was used. Setting: Orthopaedic department at a Regional Hospital in Denmark. Subjects: Two convenience samples of 20 total hip replacement patients were included. Intervention: The tests were performed three months after total hip replacement. Two raters performed test and re-test, with two hours rest in-between. Main measures: The test battery included: sit-to-stand performance, 20-metre maximum walking speed, stair climb performance, isometric muscle strength (hip abduction/flexion), and leg extension power. Absolute reliability was assessed with Bland Altman plots, standard error of measurement (SEM), and minimal detectable change. Relative reliability was assessed with intra-class correlation coefficient. Results: Systematic differences between testers were seen in tests of walking speed (0.32 seconds p = 0.03) and stair climb performance (0.18 seconds p = 0.003). In per cent of the grand mean, the standard error of measurement was 3%–10%, indicating the measurement error on a group level, and the minimal detectable change was 10%–27%, indicating the measurement error on an individual level. The intra-class correlation coefficients were above 0.80 in all tests (range 0.83–0.95). Conclusions: The tests showed acceptable relative and absolute inter-rater reliability on a group level, but not on an individual level (except from test of walking speed and stair climb performance). Systematic differences between testers were considered clinically irrelevant (0.3 and 0.2 seconds).
Collapse
Affiliation(s)
- Lone Ramer Mikkelsen
- Interdisciplinary Research Unit, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Søren Mikkelsen
- Interdisciplinary Research Unit, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Kjeld Søballe
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Inger Mechlenburg
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | | |
Collapse
|
42
|
Bennell K, Hinman RS, Wrigley TV, Creaby MW, Hodges P. Exercise and osteoarthritis: cause and effects. Compr Physiol 2013; 1:1943-2008. [PMID: 23733694 DOI: 10.1002/cphy.c100057] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Osteoarthritis (OA) is a common chronic joint condition predominantly affecting the knee, hip, and hand joints. Exercise plays a role in the development and treatment of OA but most of the literature in this area relates to knee OA. While studies indicate that exercise and physical activity have a generally positive effect on healthy cartilage metrics, depending upon the type of the activity and its intensity, the risk of OA development does appear to be moderately increased with sporting participation. In particular, joint injury associated with sports participation may be largely responsible for this increased risk of OA with sport. Various repetitive occupational tasks are also linked to greater likelihood of OA development. There are a number of physical impairments associated with OA including pain, muscle weakness and altered muscle function, reduced proprioception and postural control, joint instability, restricted range of motion, and lower aerobic fitness. These can result directly from the OA pathological process and/or indirectly as a result of factors such as pain, effusion, and reduced activity levels. These impairments and their underlying physiology are often targeted by exercise interventions and evidence generally shows that many of these can be modified by specific exercise. There is currently little clinical trial evidence to show that exercise can alter mechanical load and structural disease progression in those with established OA, although a number of impairments, that are amenable to change with exercise, appears to be associated with increased mechanical load and/or disease progression in longitudinal studies.
Collapse
Affiliation(s)
- Kim Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Australia.
| | | | | | | | | |
Collapse
|
43
|
Association of cartilage defects, and other MRI findings with pain and function in individuals with mild-moderate radiographic hip osteoarthritis and controls. Osteoarthritis Cartilage 2013; 21:1685-92. [PMID: 23948977 PMCID: PMC3804140 DOI: 10.1016/j.joca.2013.08.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 07/12/2013] [Accepted: 08/03/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the relationship of hip radiographic osteoarthritis (ROA) and MRI findings of cartilage lesions, labral tears, bone marrow edema-like lesions (BMELs) and subchondral cysts with self-reported and physical function. DESIGN Eighty five subjects were classified as controls (n = 55, Kellgren-Lawrence (KL) 0, 1) or having mild-moderate ROA (n = 30, KL 2, 3). T2 weighted MRI images at 3-T were graded for presence of cartilage lesions, labral tears, BMELs and subchondral cysts. Posterior wall sign, cross-over sign, center-edge angle and alpha angle were also recorded. Function was assessed using Hip dysfunction and Osteoarthritis Outcome Score (HOOS), Timed-Up and Go (TUG) test and Y-Balance Test (YBT). Analysis compared function between subjects with and without ROA and those with and without femoral or acetabular cartilage lesions, adjusted for age. Non-parametric correlations were used to assess the relationship between radiographic scores, MRI scores and function. RESULTS Subjects with acetabular cartilage lesions had worse HOOS (Difference = 5-10%, P = 0.036-0.004), but not TUG or YBT, scores. Acetabular cartilage lesions, BMELs and subchondral cysts were associated with worse HOOS scores (ρ = 0.23-0.37, P = 0.041-0.001). Differences in function between subjects with and without ROA or femoral cartilage lesions were not significant. Other radiologic findings were not associated with function. CONCLUSIONS Acetabular cartilage defects, but not femoral cartilage defects or ROA, were associated with greater self-reported pain and disability. BMELs and subchondral cysts were related to greater hip related self-reported pain and disability. None of the radiographic or MRI features was related to physical function.
Collapse
|
44
|
Affiliation(s)
- Kim Bennell
- Department of Physiotherapy, The University of Melbourne, Australia.
| |
Collapse
|
45
|
Judd DL, Thomas AC, Dayton MR, Stevens-Lapsley JE. Strength and functional deficits in individuals with hip osteoarthritis compared to healthy, older adults. Disabil Rehabil 2013; 36:307-12. [PMID: 23659184 DOI: 10.3109/09638288.2013.790491] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Hip osteoarthritis (OA) compromises quality of life for many individuals. This study quantified deficits in functional capacity for use in rehabilitation goal setting by combining assessments of muscle strength, function and physical activity in patients with hip OA and healthy adults. METHOD Twenty-six patients with end-stage hip OA and 18 healthy adults participated. Isometric muscle strength around the hip and knee was measured. Function was assessed using stair climbing, five-time-sit-to-stand, timed-up-and-go and 6-minute walk tests. The UCLA activity rating scale assessed physical activity. Analyses of covariance (ANCOVA) were used to assess differences between groups. RESULTS Patients had 30% less knee extensor (p < 0.001), 38% less knee flexor (p < 0.001), 10% less hip flexor (p = 0.47), 23% less hip extensor (p = 0.24) and 17% less hip abductor strength (p = 0.23) than healthy adults. Hip adductor strength was equal between groups (p = 0.93). Patients were 50% slower on the stair climbing test (p = 0.001), 34% slower on the timed-up-and-go test (p = 0.004), 34% slower on the five-time-sit-to-stand test (p = 0.001), and walked 28% less during the 6-min walk test (p < 0.001). Patients were less physically active (p = 0.001). CONCLUSIONS Patients had deficits in muscle strength, function and physical activity compared to healthy adults. Quantifying these deficits provides benchmarks for improvement during rehabilitation. IMPLICATIONS FOR REHABILITATION Hip osteoarthritis (OA) affects up to 28% of adults over the age of 65 and many individuals report functional and activity limitations directly related to their arthritic condition, posing a risk for future morbidity Total hip arthroplasty (THA) is the treatment of choice for decreasing pain and improving function, however, some individuals suffering from end-stage hip OA are not candidates for THA, and effective rehabilitation interventions to improve physical function are crucial Establishing estimates of the deficits in muscle strength, physical function and physical activity in people with and without hip OA can aid rehabilitation professionals in their goal setting and intervention planning Rehabilitation interventions should not only consist of muscle strengthening and functional training, but interventions to improve physical activity levels are required to improve overall physical functioning and to decrease risks for additional health complications.
Collapse
|
46
|
Kemp JL, Schache AG, Makdissi M, Sims KJ, Crossley KM. Greater understanding of normal hip physical function may guide clinicians in providing targeted rehabilitation programmes. J Sci Med Sport 2012; 16:292-6. [PMID: 23266242 DOI: 10.1016/j.jsams.2012.11.887] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 10/27/2012] [Accepted: 11/16/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES This study investigated tests of hip muscle strength and functional performance. The specific objectives were to: (i) establish intra- and inter-rater reliability; (ii) compare differences between dominant and non-dominant limbs; (iii) compare agonist and antagonist muscle strength ratios; (iv) compare differences between genders; and (v) examine relationships between hip muscle strength, baseline measures and functional performance. DESIGN Reliability study and cross-sectional analysis of hip strength and functional performance. METHODS In healthy adults aged 18-50years, normalised hip muscle peak torque and functional performance were evaluated to: (i) establish intra-rater and inter-rater reliability; (ii) analyse differences between limbs, between antagonistic muscle groups and genders; and (iii) associations between strength and functional performance. RESULTS Excellent reliability (intra-rater ICC=0.77-0.96; inter-rater ICC=0.82-0.95) was observed. No difference existed between dominant and non-dominant limbs. Differences in strength existed between antagonistic pairs of muscles: hip abduction was greater than adduction (p<0.001) and hip ER was greater than IR (p<0.001). Men had greater ER strength (p=0.006) and hop for distance (p<0.001) than women. Strong associations were observed between measures of hip muscle strength (except hip flexion) and age, height, and functional performance. CONCLUSIONS Deficits in hip muscle strength or functional performance may influence hip pain. In order to provide targeted rehabilitation programmes to address patient-specific impairments, and determine when individuals are ready to return to physical activity, clinicians are increasingly utilising tests of hip strength and functional performance. This study provides a battery of reliable, clinically applicable tests which can be used for these purposes.
Collapse
Affiliation(s)
- Joanne L Kemp
- University of Queensland, Division of Physiotherapy, School of Health and Rehabilitation Sciences, St Lucia, QLD 4072, Australia.
| | | | | | | | | |
Collapse
|
47
|
Poulsen E, Christensen HW, Penny JØ, Overgaard S, Vach W, Hartvigsen J. Reproducibility of range of motion and muscle strength measurements in patients with hip osteoarthritis - an inter-rater study. BMC Musculoskelet Disord 2012; 13:242. [PMID: 23217149 PMCID: PMC3565957 DOI: 10.1186/1471-2474-13-242] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 11/30/2012] [Indexed: 11/25/2022] Open
Abstract
Background Assessment of range of motion (ROM) and muscle strength is fundamental in the clinical diagnosis of hip osteoarthritis (OA) but reproducibility of these measurements has mostly involved clinicians from secondary care and has rarely reported agreement parameters. Therefore, the primary objective of the study was to determine the inter-rater reproducibility of ROM and muscle strength measurements. Furthermore, the reliability of the overall assessment of clinical hip OA was evaluated. Reporting is in accordance with proposed guidelines for the reporting of reliability and agreement studies (GRRAS). Methods In a university hospital, four blinded raters independently examined patients with unilateral hip OA; two hospital orthopaedists independently examined 48 (24 men) patients and two primary care chiropractors examined 61 patients (29 men). ROM was measured in degrees (deg.) with a standard two-arm goniometer and muscle strength in Newton (N) using a hand-held dynamometer. Reproducibility is reported as agreement and reliability between paired raters of the same profession. Agreement is reported as limits of agreement (LoA) and reliability is reported with intraclass correlation coefficients (ICC). Reliability of the overall assessment of clinical OA is reported as weighted kappa. Results Between orthopaedists, agreement for ROM ranged from LoA [-28–12 deg.] for internal rotation to [-8–13 deg.] for extension. ICC ranged between 0.53 and 0.73, highest for flexion. For muscle strength between orthopaedists, LoA ranged from [-65–47N] for external rotation to [-10 –59N] for flexion. ICC ranged between 0.52 and 0.85, highest for abduction. Between chiropractors, agreement for ROM ranged from LoA [-25–30 deg.] for internal rotation to [-13–21 deg.] for flexion. ICC ranged between 0.14 and 0.79, highest for flexion. For muscle strength between chiropractors, LoA ranged between [-80–20N] for external rotation to [-146–55N] for abduction. ICC ranged between 0.38 and 0.81, highest for flexion. Weighted kappa for the overall assessment of clinical hip OA was 0.52 between orthopaedists and 0.65 between chiropractors. Conclusions Reproducibility of goniometric and dynamometric measurements of ROM and muscle strength in patients with hip OA is poor between experienced orthopaedists and between experienced chiropractors. Orthopaedists and chiropractors can to a moderate degree differentiate between hips with or without osteoarthritis.
Collapse
Affiliation(s)
- Erik Poulsen
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
| | | | | | | | | | | |
Collapse
|
48
|
Dobson F, Choi YM, Hall M, Hinman RS. Clinimetric properties of observer-assessed impairment tests used to evaluate hip and groin impairments: A systematic review. Arthritis Care Res (Hoboken) 2012; 64:1565-75. [DOI: 10.1002/acr.21707] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
|
49
|
Juhakoski R, Malmivaara A, Lakka TA, Tenhonen S, Hannila ML, Arokoski JPA. Determinants of pain and functioning in hip osteoarthritis - a two-year prospective study. Clin Rehabil 2012; 27:281-7. [PMID: 22843354 DOI: 10.1177/0269215512453060] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To identify predictors of pain and disability in hip osteoarthritis. DESIGN A prospective analysis of determinants of pain and functioning in hip osteoarthritis. STUDY SETTING Rehabilitation clinic in a central hospital. PATIENTS A total of 118 men and women aged 55-80 years who had radiologically diagnosed hip osteoarthritis and associated clinical symptoms and participated in a randomized controlled trial. MAIN MEASURES The self-reported disease-specific pain and physical function were assessed using the pain and functioning subscales of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis index. The self-reported generic physical and mental functioning were assessed by using the Finnish-validated SF-36-item Health Survey RAND-36 subscales for function and physical and mental component summary scores. Outcome measures were recorded at 0, 3, 6, 12, 18 and 24 months. RESULTS Multivariate linear mixed model analyses revealed that lower disease-specific pain score and better functioning (WOMAC) were predicted by higher educational level (9.61 (3.15 to 16.07); 9.07 (2.05 to 16.09)), supervised exercise training (-10.13 (-17.87 to -2.39); -11.58 (-19.40 to -3.77)), habitual conditioning physical activity (-0.48 (-0.96 to -0.01); -0.39 (-0.84 to 0.05)), absence of comorbidities (-6.30 (-12.35 to -0.24); -7.87 (-14.45 to -1.30)) and absence of additional knee osteoarthritis (-7.62 (-13.87 to -1.36); -8.02 (-14.81 to -1.23)), respectively. The same factors, except for the comorbidities, also predicted general physical functioning score (RAND-36). CONCLUSIONS Higher education, absence of knee osteoarthritis and comorbidities, supervised exercise training and habitual conditioning physical activity predicted a lower presence of pain and better functional status in patients with hip osteoarthritis.
Collapse
Affiliation(s)
- Riikka Juhakoski
- Department of Physical and Rehabilitation Medicine, Mikkeli Central Hospital, Mikkeli, Finland.
| | | | | | | | | | | |
Collapse
|
50
|
Functional performance after hip resurfacing or total hip replacement: a comparative assessment with non-operated subjects. Orthop Traumatol Surg Res 2012; 98:1-7. [PMID: 22257765 DOI: 10.1016/j.otsr.2011.10.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2010] [Revised: 09/04/2011] [Accepted: 10/13/2011] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Several studies reported better clinical results with total hip resurfacing than with conventional total hip replacement, including in young patients, but without comparative stabilometry assessment. HYPOTHESIS Resurfacing arthroplasty provides better functional performance than conventional total hip replacement. OBJECTIVES To test the above hypothesis in a stabilometry study comparing balance and functional performance in patients with total hip resurfacing or conventional total hip replacement and healthy controls. MATERIALS AND METHODS Results were analyzed on three cohorts of 20 patients: healthy control subjects, with unilateral total hip replacement or unilateral total hip resurfacing. The 40 operated patients were comparable in gender, age, weight (body-mass index), date of operation and clinical results. The 20 control subjects were younger and served as reference. Balance analysis employed a force platform commonly used in stabilometry, standardizing both leg or single leg stance balance analysis. The software interpreted individual balance by measuring plantar pressure center variation during the analysis so as to contour an individual both leg or single leg area of balance (statokinesigram, in mm(2)). RESULTS Balance analysis on both leg found comparable results in the control and resurfacing groups. The weight-bearing statokinesigraphic both leg balance area was greater in the hip replacement than in either of the other two groups (p<0.05), and five times greater than in the resurfacing group (p<0.05). The single leg weight-bearing balance results were significantly better in the resurfacing group, with a statokinesigraphic balance area half that of the hip replacement group, whether on the operated or the non-operated side (p<0.001). DISCUSSION AND CONCLUSION The present functional performance results confirm the advantage of resurfacing over conventional hip replacement, and help explain the excellent radioclinical results reported for total hip resurfacing. LEVEL OF EVIDENCE III, comparative case-control study.
Collapse
|