Bakker, Lotte (L.R.) (2024) The gait pattern of patients after an acetabular fracture - a comparison with healthy subjects. thesis, Medicine.
Full text available on request.Abstract
Introduction: An acetabular fracture (AFx) is a severe injury with bimodal causes: high-energy trauma (HET) from incidents like vehicular accidents or falls, and low-energy trauma (LET). The incidence of AFx is about three patients per 100,000 annually and AFx cases are mostly male, averaging 48 years old. Treatment can be conservative for stable fractures or surgical for unstable ones. Surgical intervention often weakens hip muscles, which may have an impact on gait function. Few studies about this topic have been done but research shows a significant deficit in hip muscle strength after the injury and surgery, leading to altered gait patterns. Thirty-five percent of patients exhibit an abnormal gait a decade post-surgery, affecting mobility and quality of life. This study aims to investigate recovery of gait kinematics and spatiotemporal variables in AFx patients compared to healthy controls, to understand long-term effects and improve rehabilitation strategies. Insight into gait recovery post-AFx is crucial for enhancing patient outcomes and filling knowledge gaps in current literature. Methods: This prospective cohort study was conducted at UMC Groningen's Motion Lab and included 14 patients (13 males, 1 female, mean age 53 years) who underwent surgery for their AFx, along with 9 matched healthy controls. Gait analyses were performed at three intervals post-surgery (3, 6, and 12 months) for patients and once for controls. Data were captured using the Vicon Nexus motion capture system and AMTI force plates. Participants walked at self-selected and standardized speeds (3,6 km/h). Key outcomes included the kinematic parameters pelvic drop/tilt and hip abduction/adduction, and spatiotemporal parameters gait speed, cadence, and step length. Statistical analysis involved calculating mean values and comparing patient results over time and to controls using Student's t-tests and repeated-measures ANOVA. Results: Kinematic measurements at 3, 6, and 12 months post-surgery showed no significant differences between patients and controls, though trends indicated progressive divergence in pelvic tilt/drop and hip abduction/adduction. Spatiotemporal parameters revealed significant changes within the patient group over time, particularly an increase in gait speed and stride length during self-selected speed, moving closer to or surpassing control values. Cadence during self-selected speed differed significantly from controls at 3 months post-surgery (p = 0.04). Overall, while kinematic differences were not statistically significant, spatiotemporal improvements were notable, showing functional gait recovery over the follow-up period. Conclusion: This study represents one of the first comprehensive investigations into gait variables over an extended post-surgical period in AFx patients, comparing findings with matched healthy controls. While kinematic differences were not pronounced, notable improvements in spatiotemporal parameters, particularly gait speed and stride length, underscored significant functional recovery. These findings emphasize the critical importance of understanding gait dynamics post-AFx to optimize rehabilitation strategies and enhance long-term patient outcomes.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Reininga, I.H.F. and Hijmans, J.M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 21 Aug 2024 11:07 |
| Last Modified: | 21 Aug 2024 11:07 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3744 |
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