A biomechanical analysis of gait disturbances in a patient following alloplasty of the hip joint

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

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The use of high-tone power therapy in the rehabilitation of patients with coxarthrosis

Anna Mika, Paweł Polak

Anna Mika, Paweł Polak – The use of high-tone power therapy in the rehabilitation of patients with coxarthrosis. Fizjoterapia Polska 2007; 7(4); 401-408

Abstract
Background. The aim of this study was to assess the effect of high-tone power therapy on complaints related to coxarthrosis, i. e. reduced range of motion and pain. Material and methods. 12 subjects (aged 48-80) suffering from coxarthrosis received a series of 10 high-tone power (HiToP) therapy procedures. Additionally, 20 minutes of exercise was applied after each HiToP session. The subjects were evaluated for hip range of motion and pain level three times: before starting treatment (baseline), after the 5th session and on completion of the treatment (after the 10th session on the last day of the treatment). Results. Statistically significant changes in the functional parameters and pain level in comparison to baseline values were observed after the 5th visit. After the 10th visit, there was a significant increase in the hip range of motion in all planes assessed and a decrease in pain level. Conclusion. The treatment of coxarthrosis using high-tone power therapy and postisometric relaxation had a beneficial effect on the range of motion in the hip and coxarthrosis-related pain in the study group.
Key words:
coxarthrosis, high-tone power therapy, physiotherapy
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Assessment of the Effectiveness of the Physiotherapy in Patients with the Coxarthrosis, Treated in Spa Facilities

Zbigniew Śliwiński, Marlena Maskiera, Marta Makara-Studzińska, Grzegorz Śliwiński, Małgorzata Starczyńska

Z. Śliwiński, M. Maskiera, M. Makara-Studzińska, G. Śliwiński, M. Starczyńska: Assessment of the Effectiveness of the Physiotherapy in Patients with the Coxarthrosis, Treated in Spa Facilities. FP

Abstract
Introduction. The objective of this study has been to assess the effectiveness of the physiotherapy in patients with the coxarthrosis, treated in Spa facilities. Materials and Methods. The study involved 49 patients (29 women and 20 men), who have been treated in the “Słowacki” Spa in Busko-Zdrój, during their 21 days rehabilitation stay. The patients have had degenerative changes in the hip joint, which have not been surgically treated. The patients have been divided into two groups. To the study group (24 persons) the physiotherapy treatments have been applied. In the control group (25 persons), in addition there has been the kinezytherapy applied. Each of the patients has gone through: questionnaire survey, measurement of the range motion in the hip joints, muscle strength evaluation with the Lovett scale, assessment of the pain severity in the VAS scale, functional tests (Linder 2, abdominal compression test, Patrick Faber test, SLR, Tinetti test,”Up & Go” test, gait analysis according to Perry). Results. After the 21-day rehabilitation treatment, the majority of patients have shown a significant decrease in the subjective pain sensation, a significant improvement of the hip motion functions and a reduced risk of the patient falling down. The carried out research has indicated, that better results have been achieved in the control group, where the kinezytherapy treatment has been applied in addition. Conclusions. 1. Physiotherapy has an impact on increasing the hip joint range of motion, in all directions, particularly in the flexion an abduction movements. 2. The rehabilitation procedure improve the gait stereotype in patients with the osteoarthritis of the hip joint. 3. The Spa rehabilitation therapy reduces the risk of falling down in patients with degenerative changes in the hip joints.

Key words:
Rehabilitation, physiotherapy, coxarthrosis, spa therapy treatment

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