Altering asymmetric limb loading after hip arthroplasty using real-time dynamic feedback when walking.

Abstract

To evaluate a walking program incorporating real-time biofeedback to reduce asymmetric limb loading after total hip arthroplasty (THA). Within-subject clinical intervention. Biomechanics laboratory. Volunteers were screened for confounding disorders that could affect their gait other than unilateral THA. Participants included 28 subjects who were evaluated a minimum of 2 months after surgery and ambulatory without assistive devices. THA subjects were assigned to a feedback, no-feedback, or control group. The feedback group walked on a treadmill 15 minutes, 3 times a week for 8 weeks while matching step-to-step reaction forces. Subjects walking without feedback had equal time. The control group did not train. Symmetry indices for peak limb-loading force, rate of rise of loading force, and impulse calculated from vertical foot-ground forces. Symmetry index changes were evaluated using 2-factor, repeated-measures analyses of variance with a Tukey post hoc test. Loading rate and impulse equalization improved for the feedback group (P<.01). Loading rate equalization improved for the no-feedback group (P=.01). There were no changes for the control group. This preliminary study suggests that a treadmill walking program may help persons with a THA achieve a more symmetric gait. Additional investigation of the potential benefits of a rehabilitation program incorporating treadmill walking with and without biofeedback is recommended.