Altering asymmetric limb loading after hip arthroplasty using real-time dynamic feedback when walking

Arch Phys Med Rehabil. 2005 Oct;86(10):1958-63. doi: 10.1016/j.apmr.2005.04.010.


Objective: To evaluate a walking program incorporating real-time biofeedback to reduce asymmetric limb loading after total hip arthroplasty (THA).

Design: Within-subject clinical intervention.

Setting: Biomechanics laboratory.

Participants: Volunteers were screened for confounding disorders that could affect their gait other than unilateral THA. Participants included 28 subjects who were evaluated a minimum of 2 months after surgery and ambulatory without assistive devices.

Interventions: THA subjects were assigned to a feedback, no-feedback, or control group. The feedback group walked on a treadmill 15 minutes, 3 times a week for 8 weeks while matching step-to-step reaction forces. Subjects walking without feedback had equal time. The control group did not train.

Main outcome measures: Symmetry indices for peak limb-loading force, rate of rise of loading force, and impulse calculated from vertical foot-ground forces. Symmetry index changes were evaluated using 2-factor, repeated-measures analyses of variance with a Tukey post hoc test.

Results: Loading rate and impulse equalization improved for the feedback group (P<.01). Loading rate equalization improved for the no-feedback group (P=.01). There were no changes for the control group.

Conclusions: This preliminary study suggests that a treadmill walking program may help persons with a THA achieve a more symmetric gait. Additional investigation of the potential benefits of a rehabilitation program incorporating treadmill walking with and without biofeedback is recommended.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Analysis of Variance
  • Arthroplasty, Replacement, Hip*
  • Biofeedback, Psychology*
  • Biomechanical Phenomena
  • Exercise Test
  • Female
  • Gait / physiology*
  • Humans
  • Leg / physiopathology*
  • Male
  • Middle Aged
  • Walking / physiology*
  • Weight-Bearing / physiology