title: The effect of an external hip joint stabiliser on gait function after surgery for tumours located around the circumference of the pelvis: analysis of seven cases of internal hemipelvectomy or proximal femur resection.
abstract: OBJECTIVE
  Limb-sparing resection of malignant pelvic tumours provides the opportunity for patients to obtain better post-operative mobility. However, because few studies have examined in detail the gait function of patients following pelvic tumour resection, the factors affecting gait performance remain to be clarified. Here, with the laboratory-based computer-assisted gait analysis, we evaluated these patients' gait objectively and the impact of a hip-stabilising supporter on gait improvement was simultaneously examined.
  
  
  METHODS
  Three-dimensional gait analysis was performed to obtain cross-sectional data for seven post-operative patients (mean age, 42.7 years; range, 20-61 years) who underwent various types of resection, including P1/4 internal hemipelvectomy (IH), P1/2/3 IH, and proximal femur resection with prosthetic reconstruction. To assess the immediate effects of a hip joint stabiliser, we instructed subjects to walk at their self-selected preferred speed and compared gait parameters with and without use of the hip stabiliser.
  
  
  RESULTS
  At baseline, the average walking speed was 0.75 m/s (95% CI 0.53-0.97). As shown by the intra-subject comparison, the hip stabiliser increased walking speed in all but one subject, increasing both temporal and spatial parameters. Ground reaction force of operated limbs increased for some subjects, while step length increased on at least one side in all subjects.
  
  
  CONCLUSIONS
  Improvement in the gait parameters is indicative of better control provided by the external hip stabiliser over the affected limb. Moreover, our findings show the potential of a biomechanical approach to improve gait function following pelvic tumour resection.
authors.affiliation: Department of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Akiyama
authors.affiliation: Department of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Saita
authors.affiliation: Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Ogura
authors.affiliation: Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Kawai
authors.affiliation: Department of Orthopaedic Oncology and Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
authors.forename: Jungo
authors.initials: J
authors.lastname: Imanishi
authors.affiliation: Department of Orthopaedic Oncology and Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Yazawa
authors.affiliation: Department of Rehabilitation for the Movement Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, 4-1 Namiki, Tokorozawa, Saitama, 359-8555, Japan.
authors.forename: Noritaka
authors.initials: N
authors.lastname: Kawashima
authors.affiliation: Department of Rehabilitation for the Movement Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, 4-1 Namiki, Tokorozawa, Saitama, 359-8555, Japan. ogata-toru@rehab.go.jp.
authors.forename: Toru
authors.identifier: http://orcid.org/0000-0001-9011-8640
authors.initials: T
authors.lastname: Ogata
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005269:Femur / Q000601:surgery*; D005684:Gait / Q000502:physiology*; D006428:Hemipelvectomy / Q000379:methods*; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000601:surgery*; D010388:Pelvis / Q000503:physiopathology / Q000601:surgery; D016138:Walking / Q000502:physiology; D055815:Young Adult
keywords: Motion analysis; Orthotics; Reconstruction surgery; Tumour resection