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Nozaki K, Nanri Y, Kawabata M, Shibuya M, Nihei M, Shirota T, Masuma H, Maeda T, Fukushima K, Uchiyama K, Takahira N, Takaso M. Association of affected and non-affected side ability with postoperative outcomes in patients undergoing total hip arthroplasty. Hip Int 2024; 34:33-41. [PMID: 37720956 DOI: 10.1177/11207000231199169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
BACKGROUND Although several reports have examined the association between preoperative function and postoperative outcomes in patients undergoing total hip arthroplasty (THA), it is unclear whether the ability of the affected or non-affected side particularly impacts on outcomes. We aimed to investigate the association between affected and non-affected side ability and walking independence. METHODS We prospectively enrolled 721 consecutive patients who underwent THA. Preoperatively, quadriceps isometric strength (QIS) and one-leg standing time (OLST) were measured. The endpoints were walking independence within 3, 5, 7, 10, and 14 days postoperatively. The associations between preoperative abilities and outcomes were examined using multivariate Cox hazard model, and the area under the curves (AUCs) for outcomes were compared. RESULTS We analysed 540 patients after excluding patients who met the exclusion criteria. Both affected and non-affected QIS predicted walking independence within 3 (p = 0.006 and 0.001, respectively), 5, 7, 10, and 14 (both p < 0.001) days postoperatively. For OLST, only the affected side did not predict walking independence within 3 days postoperatively (p = 0.154 and 0.012, respectively), and both sides did at days 5 (p = 0.019 and <0.001, respectively), 7, 10, and 14 (both p < 0.001). The AUCs of the non-affected side ability for walking independence were significantly greater than those of the affected side on postoperative days 3 (0.66 vs. 0.73; p = 0.021) and 5 (0.67 vs. 0.71; p = 0.040), with no significant difference after day 7. CONCLUSIONS Both sides abilities were associated with walking independence after THA, but non-affected side was found to be particularly crucial for early walking independence.
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Affiliation(s)
- Kohei Nozaki
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Yuta Nanri
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Masashi Kawabata
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Manaka Shibuya
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Manami Nihei
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Takehiro Shirota
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Hiroyoshi Masuma
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Takuya Maeda
- Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan
| | - Kensuke Fukushima
- Department of Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Katsufumi Uchiyama
- Department of Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan
- Department of Patient Safety and Healthcare Administration, Kitasato University School of Medicine, Sagamihara, Japan
| | - Naonobu Takahira
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
- Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - Masashi Takaso
- Department of Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan
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Gialanella B, Comini L, Prometti P. Determinants of improvement in functional abilities in peripheral neuropathy patients undergoing rehabilitation: the role of Berg Balance Scale items. Acta Neurol Belg 2023; 123:173-179. [PMID: 34608595 DOI: 10.1007/s13760-021-01806-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 09/15/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE This prospective observational cohort study aimed to verify whether single Berg Balance Scale (BBS) items were important determinants of improvement in functional abilities in patients with peripheral neuropathy (PN). METHODS Data were collected in 75 older patients with PN performing a standard motor rehabilitation program. Backward stepwise multiple regression analyses were performed to identify determinants of outcome measures. Gain in total and motor Functional Independence Measure (FIM) and gain in motor-FIM areas were the outcome measures. RESULTS Among BBS items, at the end of rehabilitation, the score was higher in "sitting unsupported" (3.94 ± 0.22) and lower in "standing on one foot" (1.18 ± 1.06). The gain was higher in "standing to sitting" (1.02 ± 0.67) and "standing unsupported" (1.00 ± 1.00), and lower in "sitting unsupported" (0.22 ± 0.60) and "standing on one foot" (0.65 ± 0.77). "Standing unsupported" was the only determinant of gain in motor-FIM (beta - 0.36, p = 0.002) and gain in self-care (beta - 0.37, p = 0.002). The R2 value of the models was 0.13 and 0.14, respectively. No independent variable was a determinant of gain in total-FIM. CONCLUSIONS The study shows that "unsupported standing" is an important determinant of results of ADL rehabilitation in PN patients and indicates that ability to stand without support for a fairly long time is an essential requirement to achieve with rehabilitation higher gain levels in functional abilities in PN patients.
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Affiliation(s)
- Bernardo Gialanella
- Istituti Clinici Scientifici Maugeri IRCCS, Operative Unit for Recovery and Functional Rehabilitation of the Institute of Lumezzane, Via G Mazzini, 129, 25065, Lumezzane, Brescia, Italy.
| | - Laura Comini
- Istituti Clinici Scientifici Maugeri IRCCS, Scientific Direction of the Institute of Lumezzane, Brescia, Italy
| | - Paola Prometti
- Istituti Clinici Scientifici Maugeri IRCCS, Operative Unit for Recovery and Functional Rehabilitation of the Institute of Lumezzane, Via G Mazzini, 129, 25065, Lumezzane, Brescia, Italy
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PAPAKONSTANTINOU KN, KOTTAS-LOIZOS A, KYRITSI M, PAPADOPOULOU A, MANESIS D, MENDRINOS N, POULINAKIS A, SIOUTIS P, SOLDATOS G, KARATHANASIS F. The immediate effect of a fatigue-inducing protocol on the "one-legged stance test" performance in young healthy male adults. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.21.04620-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ohmori T, Kabata T, Kajino Y, Inoue D, Kato S, Tsuchiya H. Contralateral Lower-Limb Functional Status Before Total Hip Arthroplasty: An Important Indicator for Postoperative Gait Speed. J Bone Joint Surg Am 2021; 103:1093-1103. [PMID: 33780401 DOI: 10.2106/jbjs.20.00949] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Postoperative gait speed, especially comfortable gait speed, is an important factor for predicting function after total hip arthroplasty (THA). In this study, we examined factors related to gait speed, including preoperative lower and upper-limb functional parameters and postoperative lower-limb alignment. In addition, we examined factors related to postoperative good comfortable gait speed (≥1.34 m/s: one indicator of a good clinical outcome). The purpose of this study was to determine if better preoperative functional parameters had a positive effect on postoperative gait speed. METHODS This prospective case-control study included 91 patients with hip osteoarthritis who underwent unilateral THA. Patients who had undergone a prior hip surgical procedure or had Crowe type-3 and 4 hips, complications after THA, knee osteoarthritis-related pain, and severe lumbar conditions were excluded. The 1-leg standing time (OLST) and knee extensor strength of the operatively treated side and the contralateral side and the functional reach test were examined preoperatively and at 1 year postoperatively. The leg-length discrepancy and global offset compared with the contralateral side and leg lengthening were examined using 3-dimensional models captured through computed tomographic scans. RESULTS The preoperative contralateral side OLST was a significant factor (p < 0.001) for postoperative comfortable gait speed, and the preoperative contralateral-side knee extensor strength was a significant factor (p = 0.018) for postoperative maximum gait speed. Leg-length discrepancy and differences in global offset after THA were not significant factors for postoperative gait speed. The preoperative comfortable gait speed with a cutoff value of 1.115 m/s (area under the receiver operating characteristic curve, 0.690 [95% confidence interval, 0.569 to 0.810]; p = 0.003; sensitivity of 65.5% and specificity of 74.2%) was an independent factor associated with a good postoperative comfortable gait speed. Preoperative contralateral-side OLST was a significant factor (p = 0.027) for preoperative comfortable gait speed. CONCLUSIONS The preoperative contralateral-side, lower-limb functional status is a significant factor for postoperative gait speed. Early surgical intervention before the contralateral-side function declines or a preoperative rehabilitation intervention on the contralateral side may improve THA outcome. LEVEL OF EVIDENCE Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Takaaki Ohmori
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
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Lee CH, Sun TL. Evaluation of postural stability based on a force plate and inertial sensor during static balance measurements. J Physiol Anthropol 2018; 37:27. [PMID: 30545421 PMCID: PMC6293511 DOI: 10.1186/s40101-018-0187-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 11/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous research on balance mostly focused on the assessment, training, and improvements of balance through interventions. We investigated tools commonly used to study static balance. Differences in postural stability were analyzed using multiscale entropy (MSE) and feature analysis. METHODS A force plate and inertial sensor were used to collect acceleration and center-of-pressure (COP) nonlinear signals. MSE was also used to detect fractal correlations and assess the complexity of univariate data complexity. Fifteen healthy subjects participated in the experiments. Each stood on a force plate and wore a sensor while attempting to maintain postural stability for 30 s in four randomized experiments to evaluate their static balance via a copositive experiment with eyes open/closed and with standing on one foot or both feet. A Wilcoxon-signed rank test was used to confirm that the conditions were significant. Considering the effect of the assessment tools, the influence of the visual and lower limb systems on postural stability was assessed and the results from the inertial sensor and force plate experiments were compared. RESULTS Force plate usage provided more accurate readings when completing static balance tasks based on the visual system, whereas an inertial sensor was preferred for lower-limb tasks. Further, the eyes-open-standing-on-one-foot case involved the highest complexity at the X, Y, and Z axes for acceleration and at the ML axis for COP compared with other conditions, from which the axial directions can be identified. CONCLUSIONS The findings suggested investigation of different evaluation tool choices that can be easily adapted to suit different needs. The results for the complexity index and traditional balance indicators were comparable in their implications on different conditions. We used MSE to determine the equipment that measures the postural stability performance. We attempted to generalize the applications of complexity index to tasks and training characteristics and explore different tools to obtain different results. TRIAL REGISTRATION This study was approved by the Research Ethics Committee of National Taiwan University and classified as expedited on August 24, 2017. The committee is organized under and operates in accordance with Social and Behavioral Research Ethical Principles and Regulations of National Taiwan University and government laws and regulations.
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Affiliation(s)
- Chia-Hsuan Lee
- Department of Industrial Management, National Taiwan University of Science and Technology, No. 43, Sec. 4, Keelung Road, Da'an District, Taipei, 106, Republic of China
| | - Tien-Lung Sun
- Department of Industrial Engineering and Management, Yuan Ze University, 135 Yuan Tung Road, Chungli District, Taoyuan, 320, Republic of China.
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Lee JH, Min DK, Choe HS, Lee JH, Shin SH. The effects of upper and lower limb position on symmetry of vertical ground reaction force during sit-to-stand in chronic stroke subjects. J Phys Ther Sci 2018; 30:242-247. [PMID: 29545686 PMCID: PMC5851355 DOI: 10.1589/jpts.30.242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 11/15/2017] [Indexed: 12/02/2022] Open
Abstract
[Purpose] The purpose of this study was to evaluate the influence of arm and leg posture
elements on symmetrical weight bearing during Sit to Stand tasks in chronic stroke
patients. [Subjects and Methods] The subjects were diagnosed with stroke and 22 patients
(15 males and 7 females) participated in this study. All participants performed Sit to
Stand tasks on three foot postures and two arm postures. Two force plates were used to
measure peak of vertical ground reaction force and symmetrical ratio to peak Fz. The data
were analyzed using independent t-test and two-way repeated ANOVA. [Results] The results
of this study are as follows: 1) Peak Fz placed more weight in non-paretic leg during Sit
to Stand. 2) A symmetrical ratio to Peak Fz indicated significant difference between foot
and arm posture, and had non-paretic limb supported on a step and paretic at ground level
(STP) and grasped arm posture that lock fingers together with shoulder flexion by 90°(GA)
(0.79 ± 0.09). [Conclusion] These results suggest that STP posture of the legs and GA
posture of the arms should be able to increase the use of the paretic side during Sit to
Stand behavior and induce normal Sit to Stand mechanism through the anterior tilt of the
hip in clinical practices, by which loads onto the knee joint and the ankle joint can be
reduced, and the trunk righting response can be promoted by making the back fully
stretched. The outcome of this study is expected to be a reference for exercise or
prognosis of Sit to Stand in stroke patients.
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Affiliation(s)
- Jae Hong Lee
- Department of Physical Therapy, Daegu Health College: 15 Youngsongro, Bukgu, Daegu 702-722, Republic of Korea
| | - Dong Ki Min
- Department of Physical Therapy, Daegu Health College: 15 Youngsongro, Bukgu, Daegu 702-722, Republic of Korea
| | - Han Seong Choe
- Department of Physical Therapy, Catholic University of Daegu, Republic of Korea
| | - Jin Hwan Lee
- Department of Physical Therapy, Daegu Health College: 15 Youngsongro, Bukgu, Daegu 702-722, Republic of Korea
| | - So Hong Shin
- Department of Nursing Science, Kyongbuk College of Science, Republic of Korea
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