The effectiveness of gait rehabilitation in the patients following endoprosthetic hip replacement by means of the biofeedback-based hardware videoreconstruction of the walking stereotype

Abstract

The number of surgical interventions performed for total arthroplasty of the lower extremities (TALE) grows steadily which accounts for the increasingly greater number of patients in need of high-quality and efficient rehabilitation therapy during the post-operative period. In connection with this, the evaluation and implementation of the novel rehabilitation techniques for the management of the patients after TALE is a highly topical problem. We have studied the influence of the method of the biofeedback-based hardware videoreconstruction of the walking stereotype (BOSVRH) in the patients who had undergone total hip arthroplasty during the early postoperative period. The study included three groups of patients. Those of group I (n = 65) were chosen for the training on a treadmill with BOSVRH. In group II (n = 50), the restoration of the walking stereotype was a component of exercise therapy without the use of special hardware techniques. The patients of group III (n = 40) were healthy subjects with no clinical signs of arthrosis in the medical history who served as controls. The analysis of the test results in the end of the training course for the restoration of the walking stereotype in the patients of groups I and II in comparison with the "standard" values in the patients of control group III has demonstrated a more efficient restoration of the waling stereotype in the patients of group I than in those of group II. In the former group, the analysis of the results of dynamic observation of the features of the constituent step elements revealed the improvement of their structural characteristics, the normalization of the symmetry of the load distribution between the lower extremities during walking, and the restoration of the amortization function of the operated limb. In addition, the patients of group I showed a markedly increased level of motivation and satisfaction with the treatment. The control X-ray examination of the implanted joints during the long term follow-up period did not reveal any case of displacement of the prosthetic components. It is concluded that the restoration of the walking stereotype in the patients following hip endoprosthetic hip replacement by means of the biofeedback-based hardware videoreconstruction of the walking stereotype during the early postoperative period is an efficient and safe method of the rehabilitative treatment.