Gait analysis and WOMAC are complementary in assessing functional outcome in total hip replacement

Kamiar Aminian, Hooman Dejnabadi
2006
Article

Résumé

Objective: To investigate the correlation between objective and subjective evaluation of patients with total hip replacement. Design: Prospective preliminary trial comparing the Western Ontario and McMaster University questionnaire ( WOMAC) and gait analysis preoperatively and three months postoperatively. Setting: A German academic orthopaedic centre specializing in total hip replacement surgery. Subjects: Seventeen patients ( median age 70 years) with hip osteoarthritis. Intervention: All patients had had a primary unilateral total hip replacement. Main measures: WOMAC questionnaire to assess self-perceived health status and gait analysis to determine objective gait parameters. Results: Performance of walking as well as subjective judgement of health status improved following surgery ( gait speed P = 0.0222; stride length P = 0.038; stance phase ratio P = 0.0466; WOMAC P < 0.0001). However, the correlation between gait parameters and WOMAC was poor ( r = - 0.27 or less). Correlation between changes of walking parameters and WOMAC was bad to good ( r = 0.01 to r = - 0.72). Conclusion: The WOMAC questionnaire might not reflect walking performance. The addition of gait analysis is recommended to gain objective information about the quality of gait.

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https://infoscience.epfl.ch/record/97135?ln=fr

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Gait Features Assessment in Hip Osteoarthritis and Total Hip Replaced Patients Based on an ambulatory System (Physilog)

Kamiar Aminian, Hooman Dejnabadi, Bijan Najafi, Philippe Robert

Osteoarthritis is the most frequent joint pathology throughout the world. Obtaining objective, dynamic and quantified data allowing the evaluation of patients’ progress before and after hip arthroplasty is crucial. Gait analysis can be used for evaluating improvement in such patients, since walking is the principal human physical activity. Comprehensive gait analysis usually includes kinematics, kinetics, and electromyography. A complex instrumentation is thus required that only can be installed in a dedicated laboratory. These techniques are valuable to support clinical decisions and to evaluate the results. However, in several instances, a simplified analysis, concentrated on few selected gait parameters, can be valuable as well. Recently, we have proposed a new ambulatory system for gait analysis (Physilog) and validated its performances for normal and abnormal walking (Aminian et al., 2002). The aim of this study is to show the efficacy of Physilog system for clinical gait analysis in orthopaedics

2002

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Evaluation of an ambulatory system for gait analysis in hip osteoarthritis and after total hip replacement

Kamiar Aminian, Hooman Dejnabadi, Bijan Najafi, Philippe Robert

Spatial and temporal parameters of gait have clinical relevance in the assessment of motor pathologies, particularly in orthopaedics. A new gait analysis system is proposed which consists of (a) an ambulatory device (Physilog(R)) including a set of miniature gyroscopes and a portable datalogger, and (b) an algorithm for gait analysis. The aim of this study was the validation of this system, for accuracy and clinical applicability. Eleven patients with coxarthrosis, eight patients with total hip arthroplasty and nine control subjects were studied using this portable system and also a reference motion analyzer and force plate. The small differences in the stance period (19 +/- 31 ms), stride length and velocity (0.4 +/- 9.6 cm and 2.5 +/- 8.3 cm/s, respectively), as well as thigh and shank rotations (2.4 +/- 4.3degrees and 0.3 +/- 3.3degrees, respectively), confirmed good agreement of the proposed system with the reference system. In addition, nearly the same accuracy was obtained for all three groups. Gait analysis based on Physilog(R) was also in agreement with their Harris Hip Scores (HHS): the subjects with lower scores had a greater limp, a slower walking speed and a shorter stride. This ambulatory gait analysis system provides an easy, reproducible and objective method of quantifying changes in gait after joint replacement surgery for coxarthrosis. (C) 2003 Elsevier B.V. All rights reserved.

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