Factors associated with restricted hip extension during gait in women after total hip arthroplasty.
OBJECTIVE
A decreased peak hip extension angle in the late stance phase is a major gait abnormality in patients with THA. The purpose of this study was to determine the relationship between peak hip extension angle during gait and functional impairments such as muscle weakness and the limitation in joint range of motion and to identify the clinical factors influencing peak hip extension angle during gait.


METHODS
67 female volunteers with THA were examined. Biomechanical gait analysis was performed to measure peak hip extension angle during gait. Maximal isometric strength of the hip and knee, passive hip extension range of motion, leg length discrepancy, and hip pain were assessed.


RESULTS
Peak hip extension angle during gait significantly correlated with passive hip extension range of motion (r = 0.259), hip pain (r = -0.264), isometric strengths of the hip musculature (r = 0.278-0.491), and knee extensor (r = 0.386). Stepwise multiple regression analysis revealed that hip abductor torque (β = 0.355, P = 0.001), hip pain (β = -0.353, P = 0.001), and passive hip extension range of motion (β = 0.258, P = 0.011) were significant contributors to peak hip extension angle during gait (R2 = 0.408).


CONCLUSIONS
Our findings suggest that THA rehabilitation aimed at improving gait ability should focus on strengthening the hip abductors, controlling hip pain and increasing range of motion of hip extension.
Department of Rehabilitation Science, Hyogo University of Health Sciences, Kobe - Japan.
Rui
R
Tsukagoshi
Graduate School of Medicine, Kyoto University, Kyoto - Japan.
Hiroshige
H
Tateuchi
Faculty of Rehabilitation, Kobe Gakuin University, Kobe - Japan.
Yoshihiro
Y
Fukumoto
Graduate School of Medicine, Gifu University, Gifu - Japan.
Haruhiko
H
Akiyama
Graduate School of Medicine, Kyoto University, Kyoto - Japan.
Kazutaka
K
So
Graduate School of Medicine, Kyoto University, Kyoto - Japan.
Yutaka
Y
Kuroda
Department of Orthopaedic Surgery, Rakuyo Hospital, Kyoto - Japan.
Hideo
H
Okumura
Graduate School of Medicine, Kyoto University, Kyoto - Japan.
Noriaki
N
Ichihashi
D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D015207:Osteoarthritis, Hip / Q000503:physiopathology* / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D016059:Range of Motion, Articular / Q000502:physiology*; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors