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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Musculoskeletal Disorders 1/2015

Improvement of walking speed and gait symmetry in older patients after hip arthroplasty: a prospective cohort study

BMC Musculoskeletal Disorders > Ausgabe 1/2015
Walter Rapp, Torsten Brauner, Linda Weber, Stefan Grau, Annegret Mündermann, Thomas Horstmann
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

WR conceived the study, defined the study design, overlooked the data collection and prepared the manuscript; Torsten Brauner was involved in data processing and analysis and approved the final manuscript; LW was involved in data acquisition and processing and approved the final manuscript; SG was involved in study design and data analysis and approved the final manuscript; AM analyzed the data, was involved in data interpretation and manuscript preparation; TH conceived the study and was involved in data acquisition, analysis and interpretation and manuscript preparation. All authors read and approved the final manuscript.



Retraining walking in patients after hip or knee arthroplasty is an important component of rehabilitation especially in older persons whose social interactions are influenced by their level of mobility. The objective of this study was to test the effect of an intensive inpatient rehabilitation program on walking speed and gait symmetry in patients after hip arthroplasty (THA) using inertial sensor technology.


Twenty-nine patients undergoing a 4-week inpatient rehabilitation program following THA and 30 age-matched healthy subjects participated in this study. Walking speed and gait symmetry parameters were measured using inertial sensor device for standardized walking trials (2*20.3 m in a gym) at their self-selected normal and fast walking speeds on postoperative days 15, 21, and 27 in patients and in a single session in control subjects. Walking speed was measured using timing lights. Gait symmetry was determined using autocorrelation calculation of the cranio-caudal (CC) acceleration signals from an inertial sensor placed at the lower spine.


Walking speed and gait symmetry improved from postoperative days 15–27 (speed, female: 3.2 and 4.5 m/s; male: 4.2 and 5.2 m/s; autocorrelation, female: 0.77 and 0.81; male: 0.70 and 0.79; P <0.001 for all). After the 4-week rehabilitation program, walking speed and gait symmetry were still lower than those in control subjects (speed, female 4.5 m/s vs. 5.7 m/s; male: 5.2 m/s vs. 5.3 m/s; autocorrelation, female: 0.81 vs. 0.88; male: 0.79 vs. 0.90; P <0.001 for all).


While patients with THA improved their walking capacity during a 4-week inpatient rehabilitation program, subsequent intensive gait training is warranted for achieving normal gait symmetry. Inertial sensor technology may be a useful tool for evaluating the rehabilitation process during the post-inpatient period.
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