Gait with and without forearm crutches in patients with total hip arthroplasty

There is considerable variation between centres in the use of forearm crutc hes in the rehabilitation of patients with total hip arthroplasty who are c apable of full weight bearing. This study aimed to compare the gait of pati ents with total hip arthroplasty walking with and without crutches. The gai t analysis in 19 patients included the assessment of kinematics, kinetics a nd the kinesiological electromyographic activity of lower limb and trunk mu scles. With the forearm crutches patients walked with a reduced cadence, a longer stride length and more symmetrically (P < 0.05). The activity of the gluteus medius, vastus medialis and lateralis, and erector spinae muscles of the affected and of the vastus medialis muscle of the unaffected side de creased significantly (P < 0.05). Furthermore, seven subjects displayed an abnormal activation pattern of the affected hip abductor when walking with forearm crutches, characterized by a second burst during swing (n = 5) or a tonic pattern (n = 2). It is concluded that the use of forearm crutches re sulted in a symmetrical gait pattern. The reduced activity of relevant pelv i-trochanteric muscles and the disturbed activation pattern of the affected hip abductor when walking with crutches might indicate that patients shoul d walk unaided as soon as possible to provide a more efficient muscular tra ining under dynamic conditions.