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Can visual feedback improve gait symmetry after THA?
Patients receiving technology-assisted rehabilitation showed faster walking speeds and better pelvic control, although pain relief and functional independence remained comparable.
To compare visual feedback–based rehabilitation plus conventional physiotherapy with conventional physiotherapy alone for gait and clinical outcomes after unilateral total hip arthroplasty (THA).
Approach:
Design and participants: Randomized study of 90 patients aged 55–80 years after THA via a direct lateral approach.
Interventions: For 6 weeks, 5 days per week, the visual feedback group received 30 minutes of technology-assisted training plus 30 minutes of conventional therapy; controls received 60 minutes of conventional therapy.
Assessments: Blinded assessors measured gait and pelvic kinematics with a G-WALK sensor at baseline and 6 weeks. Pain, functional independence, and ambulation capacity were also assessed.
Key Findings:
At 6 weeks, gait speed was 0.83 m/s with visual feedback and 0.74 m/s with conventional therapy; the between-group difference was 0.09 m/s.
Cadence, gait symmetry, and pelvic movement measures improved more in the visual feedback group.
Both groups improved in pain, Barthel Index, and Functional Ambulation Category, with no statistically significant between-group differences in these clinical outcomes.
Exploratory analyses identified different recovery profiles, with visual feedback participants more often represented in a higher-functioning cluster.
Interpretation:
The authors interpreted the gait and pelvic measurements as indicating better gait coordination with visual feedback rehabilitation. The 0.09-m/s gait-speed difference was below the commonly reported THA minimal clinically important difference of 0.10–0.14 m/s.
Limitations:
The modest sample came from one Italian inpatient rehabilitation center, and all participants had a direct lateral surgical approach.
Outcomes were measured only at 6 weeks, so longer-term durability is unknown.
Exploratory multivariate and clustering analyses were post hoc and lacked 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.
Conclusion:
The authors called for medium- to long-term follow-up to determine whether early gait advantages persist over 6–12 months. They reported no conflicts of interest.
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