Wiesław Chwała, Witold Serafin, Anna Marchewka

Wiesław Chwała, Witold Serafin, Anna Marchewka – A biomechanical analysis of gait disturbances in a patient following alloplasty of the hip joint. Fizjoterapia Polska 2007; 7(2), 185-197

Abstract

Background. The physical examination and imaging studies are the diagnostic tools of today’s therapists and physicians. The drawbacks of these methods include a lack of objectivity as the assessment depends on the examiner’s clinical experience and the limited possibilities of the physical examination. As attention is quite often focused on a specific clinical area, biomechanical relations with other structures in the locomotor system are neglected. Three-dimensional analysis of movement is now available to clinicians as a new method of analysis of patient locomotion that can ensure a holistic and precise whole-body diagnosis of biomechanical disturbances. Material and methods. A three-dimensional gait analysis was carried out at the Laboratory of Biokinetics of the University of Physical Education in Cracow, Poland. A 56 year-old woman with right hip coxarthrosis underwent an examination of locomotion before an elective THR at the Department of Neuroorthopedics of the Rydygier Hospital in Cracow, and four months after the sur-gical procedure, following a period of total unloading of the operated right hip, around the time she commenced unsupported ambulation without assistive forearm crutches. Results and Conclusions. Based on the three-dimensional analysis of motion, a number of gait disturbances were detected which had originated from the degenerative changes within the hip joint and were not noticed during the physical examination. A comparison of the pre- and post-operative data showed that the pathologic gait patterns were successfully altered thanks to THR. Specifically, the range of motion within the hip joint was closer to relevant biomechanical reference values. The results of the postoperative examination suggest the presence of persistent disturbances of muscle function that still necessitate compensatory work of the contralateral limb.

Key words:

three-dimensional gait analysis, coxarthrosis, THR