Balance and gait in total hip replacement: a pilot study.
OBJECTIVE
Evaluation of balance, gait changes, sexual functions, and activities of daily living in patients with total hip replacement in comparison with healthy subjects.


METHODS
A total of 30 patients were included in the study after total hip replacement. Balance was examined using dynamic posturography, and gait evaluation was done clinically. Sexual functions and activities of daily living were also assessed. A total of 30 healthy subjects of comparable age and sex served as a control group.


RESULTS
Dynamic balance and gait differed significantly in both the groups. Despite capsulectomy, no significant difference was observed on testing proprioception. In the sensory organization tests with difficult tasks, patients needed more sensory input from vision and vestibular sense, despite normal proprioceptive sense. Significant difference was observed for limits of stability, rhythmic weight shifts, and for gait variables other than walking base. Some of the patients had major difficulties with sexual functions and activities of daily living.


CONCLUSIONS
Compared with the healthy age- and sex-matched controls, patients with total hip replacement did not have any proprioceptive deficit. Patients required extrasensory input, and there was a delayed motor response. Gait and dynamic balance results also indicated the motor deficit and required a compensatory strategy. Restoration of the postural control in these patients is thus essential. Necessary training is required for balance, gait, and activities of daily living, and proper sexual counseling is necessary in postoperative care.
Nallegowda
Mallikarjuna
M
Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi.
Singh
U
U
Bhan
Surya
S
Wadhwa
Sanjay
S
Handa
Gita
G
Dwivedi
S N
SN
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D016022:Case-Control Studies; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019957:Motor Skills Disorders / Q000503:physiopathology; D010865:Pilot Projects; D004856:Postural Balance / Q000502:physiology*; D011434:Proprioception / Q000502:physiology; D011597:Psychomotor Performance / Q000502:physiology*; D012725:Sexual Behavior