The influence of visual feedback on the mental representation of gait in patients with THR: a new approach for an experimental rehabilitation strategy.

Due to total hip replacement (THR), patients reveal abnormal gait patterns which post-operative do often not return to "normal". The restoration towards normal gait reduces stress on the adjacent joints which consequently reduces risk of osteoarthrosis development. Motor-performance is related to the structure of the movement in long-term memory, thus it seems to be essential to imprint correct gait patterns in there. Mental representation structures can develop over the course of training and visual feedback presumably helps regaining a better representation of gait in long-term memory. The purpose of this study is to evaluate the effect of visual feedback on mental representation in patients with THR. In a randomized controlled trial, 20 women (57 ± 6 years) with THR have been enrolled. Subjects were randomly assigned to a control group (CG) or intervention group (IG). Additionally to inpatient treatment, all subjects participated in a standardized gait training including either an intervention based on verbal information from a physiotherapist (CG) or an intervention based on real-time visual feedback (IG). Mental representation was measured in pre-test and post-test using the structure-dimensional analysis. Results indicate significant improvements in mental representation of gait in the post-test only in IG, suggesting that beneficial effects were provoked by visual feedback.

Evaluation of a visual feedback system in gait retraining: a pilot study.

Abnormal gait pattern of the frontal plane (i.e. Duchenne gait and Trendelenburg gait) may be caused by a variety of diseases. The aim of this pilot study was to evaluate the instantaneous effect of a visual feedback system on frontal plane pelvis and trunk movements in order to use it in patients with THR in subsequent studies. A total of 24 women (45-65 years) were included in the study. According to acute functional impairments the subjects were assigned to the control group (CG, no gait disorders, n=15, age=59±11 years, BMI=27±4) or to the intervention group (IG, n=9, age=61±4, BMI=29±5), respectively. First, in Measurement 1 (M1) kinematic reference values were captured in a standardized clinical gait analysis (MVN, XSens). Afterwards, the influence of a visual real-time feedback on gait pattern was examined while using the feedback system (M2). While there was a significant difference of IG vs. CG in M1 in the mean inclination regarding pelvis and trunk movements, this was not detected in M2. Therefore it is concluded, especially in subjects with abnormal gait pattern, that the visualization leads to an improvement of the movement pattern of pelvis and trunk in the frontal plane while using the device.