None listed
Conditions
Brief summary
This study firstly aims to determine if there are differences in the post-operative recovery in terms of muscle activation, lower limb strength and balance between people who have had additional aquatic physiotherapy and those who have had standard ward treatment. The second aim is to determine if there is a relationship between the laboratory measures of muscle activation, with clinical measures of strength and function. The third is to compare the muscle activation patterns and timing at various stages of recovery of those who have had surgery with those of healthy older people. We hypothesise that, people undergoing total hip or knee replacement will demonstrate a delay in timing of muscle activation in a step task and greater variation in gait parameters in comparison to healthy elders; those who have not had additional inpatient aquatic physiotherapy after THR or TKR will demonstrate a delay in timing of muscle activation in a step task and greater variation in gait parameters than those who had aquatic physiotherapy; and there will be a positive correlation between a delay in muscle timing and reduced clinical measures of strength and function.
Interventions
A sub-group of participants in a randomised controlled trial (RCT) investigating the efficacy of inpatient aquatic physiotherapy after total hip or knee replacement surgery participated in this study (ACTRN12608000354381: "Does a specific inpatient aquatic physiotherapy program after joint replacement surgery improve strength more than additional ward physiotherapy or water exercise?"). They underwent additional laboratory investigations of muscle activation, balance and computerised gait analys
A sub-group of participants in a randomised controlled trial (RCT) investigating the efficacy of inpatient aquatic physiotherapy after total hip or knee replacement surgery participated in this study (ACTRN12608000354381: "Does a specific inpatient aquatic physiotherapy program after joint replacement surgery improve strength more than additional ward physiotherapy or water exercise?"). They underwent additional laboratory investigations of muscle activation, balance and computerised gait analysis. Participants from each of the three intervention groups of the RCT were required and two different tasks were to be measured in the laboratory. In the first, subjects are required to perform a stepping task whilst standing on force platforms and with surface electromyography (EMG) electrodes placed over 5 muscles to record muscle activation. Surface electrodes are applied to the skin overlying tensor fascia latae (TFL) bilaterally and on the gluteus medius, vastus lateralis (VL), vastus medialis (VM) of the stance leg. A ground electrode will be placed over the fibula head. The electrodes are connected to a lightweight hip pack, which is connected to an amplifier and then to an A-D board which records and displays the muscle activity in real time. Placement will be verified by the recording of a sub-maximal contraction: hip abduction in standing with the hip in neutral rotation and toes lifted 5cm from ground (TFL and gluteus medius) and knee extension (VL and VM). Subjects stand with each foot on a force platform (10cm between medial malleoli), with a 15cm high step placed 10cm in front of the toes. Tones will be played through a computer, with a high tone (5kHz) indicating to begin stepping. Two conditions will be measured. Subjects will be asked to step as quickly as possible when they hear the first tone (10 repetitions). In the second condition, subjects are required to lift their foot off at the first tone ,and land their foot on the step in time with the second tone. Subjects are measured stepping with both legs, so a total of forty steps are recorded - 10 fast and then slow steps standing on the operated leg and then 10 fast and slow steps stepping with the operated leg. The second task is for subjects to walk along a computerised walkway , completing three trials at a comfortable pace and three at a pace that is 'as fast as you safely can'.
Sponsors
The University of Queensland
Study design
Allocation
Non-randomised trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
50 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
subgroup from RCT: - be booked for total hip replacement (THR) or total knee replacement (TKR) surgery and already given consent to take part in the randomised controlled trial - able to travel to research laboratory before and after surgery healthy community-dwelling elders - no musclo-skeletal or neurological conditions that effect mobility or balance
Exclusion criteria
- insufficient time before hospital admission to attend research laboratory for pre-op assessment - live too far from research laboratory so travel to laboratory day 14 after surgery not possible
Outcome results
None listed