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Title: Analysis of hip and lumbar spine movement during functional activity two years after total hip replacement
Author: Coutts, Fiona Jane
ISNI:       0000 0004 2668 3719
Awarding Body: University of Strathclyde
Current Institution: University of Strathclyde
Date of Award: 2008
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Total Hip Replacement (THR) is considered one of the commonest, mechanically effective and cost effective orthopaedic procedures performed. Routinely patients are discharged from follow-up at 1-year after surgery and little is known about hip and lumbar spine movement during function after this time. Twenty four participants, two years after uncomplicated primary THR were compared with 24 matched healthy adults during 4 functional activities and clinical assessment of hip and lumbar spine movement. The clinical tests and hip, pelvis and lumbar spine motion during gait are presented. A6 camera, Kinemetrix Motion Analysis system(50Hz) (MIE Ltd., UK) and a single 0.4 x 0.6m Bertec force platform (300Hz) (MIE Ltd., UK) were used. Reliability testing of dynamic and clinical measures was undertaken and all data were tested for normality. Mean range and peak data were tested using Analysis of variance and post hoc t-tests. Data were analysed in three groups: Those after THR both the operated (THR op) and non-operated sides (THR non op) were investigated and compared to healthy individuals (THN). Alpha was set at p<0.05. All physiological hip movements were greater in the THN group but only lumbar spine flexion and lateral flexion were significantly larger with extension being less. During gait, the THR op side had significantly decreased mean hip range compared to the THR non op side and THN groups, whilst the THN side had significantly less mean range of lumbar spine motion in the sagittal plane. Sagittal plane peak hip moments were significantly larger in the THN group compared to the THR op. Considerable difference were identified in timing and range of the movement patterns in angle-time and angle-angle diagrams for the THN and THR groups. These findings highlight possible longer term spinal complications through abnormal mechanical use and question the effectiveness of current rehabilitation after THR.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral