Duration and frequency of every day activities in total hip patients
Introduction
Testing procedures for artificial joints (Scheller et al., 1999; Brummitt and Hardaker, 1996; Saikko, 1996; Bragdon et al., 1996; Mejia and Brierley, 1994) are based on model calculations (Ramamurti et al., 1996; van den Bogert et al., 1999), in vivo measurements (Bergmann et al., 1993; Bergmann et al., 1997; Kotzar et al., 1991) and rather general estimations of the frequency of loading situations in situ. These are presently restricted to the number of walking steps per year (Schmalzried et al., 1998; Schmalzried et al., 1996). In order to develop, test and optimize total joint replacements in a more realistic manner, a detailed profile of the duration and frequency of the most common daily activities of patients after total hip arthroplasty (THA) is required.
Furthermore, the outcome of THA is typically assessed using several different hip score systems (Bryant et al., 1993; Kilgus et al., 1991; Garellick et al., 1998; Lieberman et al., 1997). The relation between hip scores and the activity level of patients has been established for the UCLA activity rating (Zahiri et al., 1998) but not for the commonly used Harris hip score (HHS) (Harris et al., 1988). It is hypothesized that a higher HHS should be reflected by a more active daily profile. The purpose of this study was to develop and apply a system for the monitoring of total hip patient activities over whole day periods and to evaluate the relation between the individual activity profiles and the Harris hip score.
Section snippets
Methods and material
The frequency and duration of daily activities were determined based on the assumption that the activity of a patient can be identified from the inclinations of the calf and the thigh of one leg. The system was designed to be easy to use, robust and to interfere as little as possible with the normal life of the patient. Consequently the patient was visited at her/his home and equipped with the system there.
Verification measurements
Identification of the defined activities from the video recordings proved to be more difficult as expected, especially regarding the numbers of sequences of walking, stair climbing and standing (Table 4). The deviation of walking and standing sequences were due to problems in differentiating walking movements during standing periods. The deviation of stair climbing sequences were caused by a dog-legged stair with a half-pace: the classifying program identified sometimes only one instead of two
Discussion
Realistic pre-clinical testing of artificial joints is an important aspect in the improvement of durability and survival times of these implants. The data presented in this study together with information regarding in vivo hip joint forces during different activities (Bergmann et al., 1997; Bergmann et al., 1999) allow to define realistic load collectives. This concerns the number of steps walked, the number of stairs de- or ascended and the frequencies of sitting down re. getting up from a
Acknowledgements
This study was supported in part by the European Community, Contract No. SMT4-CT96-2076.
References (19)
- et al.
Hip joint forces during walking and running—measured in two patients
Journal of Biomechanics
(1993) - et al.
Outcome after total hip arthroplasty
Comparison of a traditional disease-specific and a quality-of-life measurement of outcome. Journal of Arthroplasty
(1997) - et al.
Loci of movement of selected points on the femoral head during normal gait
Three-dimensional computer simulation. Journal of Arthroplasty
(1996) - et al.
Assessing activity in joint replacement patients
Journal of Arthroplasty
(1998) - Bergmann, G., Duda, G., Deuretzbacher, G., Morlock, M., 1999. Workpackage 5: Development of the loading configuration....
- et al.
Hip joint forces during load carrying
Clinical Orthopaedics
(1997) - et al.
The importance of multidirectional motion on the wear of polyethylene
Proceedings of the Institution of Mechanical Engineers [H.]
(1996) - et al.
Estimation of wear in total hip replacement using a ten station hip simulator
Proceedings of the Institution Mechanical Engineers [H.]
(1996) - et al.
A statistical analysis of hip scores
Journal of Bone and Joint Surgery (British)
(1993)
Cited by (312)
Investigation of stair ascending and descending activities on the lifespan of hip implants
2024, Medical Engineering and PhysicsVEXLPE friction studied with a multidirectional hip joint simulator using contact temperature control
2023, Tribology InternationalNovel Use of an Accelerometer to Assess Load Asymmetry Over Time After Hip Resurfacing Arthroplasty
2023, Journal of ArthroplastyA novel portable sensor to monitor bodily positions and activities in transtibial prosthesis users
2022, Clinical BiomechanicsCitation Excerpt :Other sensing modalities besides inductive distance sensing have been pursued to try to distinguish sitting and standing. Efforts include measuring from two inclinometers, one on the calf and one on the thigh (Gardner et al., 2016; Morlock et al., 2001), adding inertial measurement units and gyros (e.g., GT9X, Actigraph), using in-shoe pressure sensing mats (Dehzangi et al., 2018; Tabor et al., 2021), and placing load cells in or above the pylon (Frossard et al., 2011). However, these modalities do not differentiate a donned from a doffed or partially doffed prosthesis.
Finite element analysis in orthopedic biomechanics
2022, Human Orthopaedic Biomechanics: Fundamentals, Devices and Applications
- 1
http://www.tu-harburg.de/bim