Clinical Scorecard: Can visual feedback improve gait symmetry after THA?

At a Glance

Key Highlights

• In this randomized study, visual feedback–based rehabilitation plus conventional therapy was compared with conventional physiotherapy alone.
• At 6 weeks, mean gait speed was 0.83 m/s with visual feedback rehabilitation and 0.74 m/s with conventional therapy; the between-group difference was 0.09 m/s.
• Gait symmetry and measured pelvic movement improved more in the visual feedback group.
• Pain and Barthel Index outcomes improved comparably in both groups; Functional Ambulation Category scores also improved, with no significant between-group difference.
• The 0.09-m/s gait-speed difference was below the commonly reported THA minimal clinically important difference of 0.10 to 0.14 m/s.

Guideline-Based Recommendations

Diagnosis

• The study assessed gait performance and pelvic kinematics at baseline and after 6 weeks using a G-WALK inertial sensor.
• Secondary measures included pain intensity (Visual Analog Scale), functional independence (Barthel Index), and ambulation capacity (Functional Ambulation Category).

Management

• The visual feedback group received 30 minutes of technology-assisted training followed by 30 minutes of conventional therapy, 5 days per week for 6 weeks.
• The comparison group received 60 minutes of conventional physiotherapy on the same schedule.

Monitoring & Follow-up

• Study evaluations included gait speed, cadence, symmetry, pelvic movement, pain, functional independence, and ambulation capacity.
• Assessments were conducted by independent evaluators blinded to treatment allocation.

Risks

• The study had a modest sample from one inpatient rehabilitation center and included only patients treated through a direct lateral approach.
• Outcomes were measured only at 6 weeks, so persistence of the observed differences is unknown.
• Exploratory multivariate and clustering analyses were conducted post hoc without prespecified power calculations; secondary gait comparisons were not adjusted for multiple testing.
• Reported between-group differences did not meet the stricter statistical threshold specified in the study tables.

Patient & Prescribing Data

Adults aged 55 to 80 years undergoing unilateral THA through a direct lateral approach; 90 patients were randomized, with no losses to follow-up.

Visual feedback rehabilitation was added to conventional therapy for 6 weeks. The study reported greater improvement in objective gait measures in the visual feedback group. The 0.09-m/s gait-speed difference was below the commonly reported 0.10-to-0.14-m/s minimal clinically important difference after THA. Clinical outcomes improved comparably between groups, with no significant between-group difference in ambulation category.

Clinical Best Practices

• The study had a 6-week follow-up, a modest sample from one inpatient rehabilitation center, and included only patients treated through a direct lateral approach.
• Objective gait measures improved more in the visual feedback group, while clinical outcomes improved comparably between groups.
• The authors called for medium- to long-term follow-up to determine whether early advantages persist over 6 to 12 months.

Related Resources & Content

• JBJS Open Access study described in the supplied article