Visual feedback gait training following total hip arthroplasty

Introduction: The purpose of this study was to examine the effects of verbal instructions and real-time visual feedback strategies based on thoracic spine kinematics for gait rehabilitation of patients following total hip replacement arthroplasty. Methods: 12 hip arthroplasty patients (44-79 yrs) participated in the study. The 3D-ultrasonic movement analysis system was used to calculate the average lateral thorax deviation as well as the thorax and pelvis side-to-side displacements during four trials in balanced order (free walking, real-time video feedback, mirror, verbal instruction). Results: During regular walking patients ambulated with an average lateral thorax deviation of 2.2 +/- 1.9 degrees. During real-time visual feedback 7 patients demonstrated significant (p < 0.05) reductions in the average lateral trunk bending position (-0.3 degrees +/- 3.3). Receiving verbal cues, 7 subjects showed a significantly (p<0.05) decreased lateral thorax deviation throughout the gait cycle (0.2 degrees +/- 2.2). During the mirror feedback trial 8 subjects reduced their medio-lateral thorax excursions (0 degrees +/- 2.6). However, no significant reductions in thorax and pelvis side-to-side displacements were noted. Conclusions: The results demonstrated that the thorax gait kinematics of arthroplasty patients could be addressed immediately by all treatments. While all techniques seem to be useful as an adjunct to standard rehabilitation programmes, verbal instructions could additionally facilitate the patient's capability to deal with the intrinsic information naturally present during everyday practice.