title: The effect of crutches, an orthosis TheraTogs, and no walking aids on the recovery of gait in a patient with delayed healing post hip fracture: A case report.
abstract: Accelerated rehabilitation following hip fracture and joint replacement, including early unrestricted weight-bearing and muscle strengthening, has gained importance in hastening functional recovery and hospital discharge. The influence of walking aids on these parameters is sparsely investigated. In this case report, we document the effect of walking with crutches; an orthotic garment and strapping system, TheraTogs; and no walking aids over 3-4-week periods on walking speed, trunk sway, and muscle activity measured with electromyography (EMG). The patient was a 49-year-old female showing delayed healing following a conservatively treated avulsion fracture of the greater trochanter 12 weeks previously with a 14-year history of total hip arthroplasty. EMG analysis showed muscle activity increased with TheraTogs and decreased with crutches compared with walking with no aids. Walking speed improved at a faster rate in the TheraTogs phase than in the crutches phase and reduced in no-walking-aids phase. Mean speed (SD) for each phase was: crutches 1.11 (0.08) m/s, TheraTogs 1.35 (0.11) m/s, and no-aids 1.19 (0.14) m/s. Trunk sway increased in the crutch and no-aids phases, and became more stable in the TheraTogs phase. In this patient, function and recovery rate of all measured parameters increased more in the TheraTogs phase than the crutches or no-aids phase. This may be because muscle activity was facilitated enabling active support of recovering structures.
authors.affiliation: a Bildungszentrum Gesundheit Basel-Stadt , Muenchenstein , Switzerland.|b Faculty of Health , Bern University of Applied Science , Bern , Switzerland.
authors.forename: Clare
authors.initials: C
authors.lastname: Maguire
authors.affiliation: c Department of Anatomy and Embryology , Maastricht University , Maastricht , The Netherlands.
authors.forename: Judith M
authors.initials: JM
authors.lastname: Sieben
authors.affiliation: a Bildungszentrum Gesundheit Basel-Stadt , Muenchenstein , Switzerland.
authors.forename: Heike
authors.initials: H
authors.lastname: Scheidhauer
authors.affiliation: d Laboratory for Movement Analysis, Basel University Children's Hospital , Basel , Switzerland.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Romkes
authors.affiliation: a Bildungszentrum Gesundheit Basel-Stadt , Muenchenstein , Switzerland.|e Reha Rheinfelden , Rheinfelden , Switzerland.
authors.forename: Zorica
authors.initials: Z
authors.lastname: Suica
authors.affiliation: f Department of Epidemiology , Maastricht University , Maastricht , The Netherlands.
authors.forename: Robert A
authors.initials: RA
authors.lastname: de Bie
mesh_terms: D003446:Crutches; D005260:Female; D005684:Gait; D006620:Hip Fractures / Q000534:rehabilitation*; D006801:Humans; D008875:Middle Aged; D009989:Orthotic Devices; D020127:Recovery of Function
keywords: Accelerated rehabilitation; hip fracture; muscle strength; unrestricted weight-bearing; walking aids