Abstract
There are multiple attempts to decrease costs in the healthcare system while maintaining a high treatment quality. Digital therapies receive increasing attention in clinical practice, mainly relating to home-based exercises supported by mobile devices, eventually in combination with wearable sensors. The aim of this study was to determine if patients following total hip arthroplasty (THA) could benefit from gait training on crutches conducted by a mobile robot in a clinical setting. Method: This clinical trial was conducted with 30 patients following total hip arthroplasty. Fifteen patients received the conventional physiotherapy program in the clinic (including 5 min of gait training supported by a physiotherapist). The intervention group of 15 patients passed the same standard physiotherapy program, but the 5-min gait training supported by a physiotherapist was replaced by 2 × 5 min of gait training conducted by the robot. Length of stay of the patients was set to five days. Biomechanical gait parameters of the patients were assessed pre-surgery and upon patient discharge. Results: While before surgery no significant difference in gait parameters was existent, patients from the intervention group showed a significant higher absolute walking speed (0.83 vs. 0.65 m/s, p = 0.029), higher relative walking speed (0.2 vs. 0.16 m/s, p = 0.043) or shorter relative cycle time (3.35 vs. 3.68 s, p = 0.041) than the patients from the control group. Conclusion: The significant higher walking speed of patients indicates that such robot-based gait training on crutches may shorten length of stay (LOS) in acute clinics. However, the number of patients involved was rather small, thus calling for further studies.
Highlights
Total hip arthroplasty (THA) is one of the most effective orthopedic surgeries to improve quality of life
Fifteen patients received the conventional physiotherapy program in the clinic
After consistent application of the inclusion and exclusion criteria such as diagnosis, primary total hip arthroplasty, age, secondary diseases, the robot group was reduced from originally 26 patients to 17 patients, and the control group from the original 21 to 20 patients
Summary
Total hip arthroplasty (THA) is one of the most effective orthopedic surgeries to improve quality of life. Most candidate patients suffer from end-stage osteoarthritis that severely affects their walking abilities. It is commonly accepted that physiotherapy after THA has a positive impact on muscle strength, range of motion, pain, or gait which all impact patient mobility [1]. Physiotherapy starts shortly after operation, primarily as inpatient therapy in the hospital where surgery took place [2,3]. It may be further organized as inpatient therapy in rehabilitation clinics, as outpatient therapy, home therapy, or combinations thereof
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