Ann Rehabil Med.  2019 Aug;43(4):474-482. 10.5535/arm.2019.43.4.474.

The Effect of Simultaneous Antigravity Treadmill Training and Electrical Muscle Stimulation After Total Hip Arthroplasty: Short Follow-Up Time

• Mikami Y
• Orita N
• Yamasaki T
• Kamijo Y
• Kimura H
• Adachi N

• KMID: 2457756
• DOI: http://doi.org/10.5535/arm.2019.43.4.474

Abstract

OBJECTIVE
To assess the effectiveness of our devised hybrid physiotherapy regime using an anti-gravity treadmill and a low-frequency electrical stimulation device, as measured in patients with hip osteoarthritis after total hip arthroplasty (THA).
METHODS
The outcomes of the postoperative rehabilitation in 44 patients who underwent THA for hip osteoarthritis were retrospectively examined. The conventional group (n=22) underwent the postoperative rehabilitation according to our protocol, while the hybrid group (n=22) underwent the same training, along with training on an anti-gravity treadmill and training using a low-frequency therapeutic device. The outcome measures were recorded and reviewed with the Numerical Rating Scale for pain, which rates pain on an 11-point scale from 0 to 10, surgical side knee joint extension force, 10-m walking test, Timed Up and Go test, and the 6-minute walking distance (6MD). The outcome measurement was taken 2 weeks after conducting pre-operation and antigravity treadmill training and electrical muscle stimulation, and compared the respective results.
RESULTS
At the timeframe of 2 weeks from the surgery after conducting a devised hybrid physiotherapy, the values of knee extension muscle strength and 6MD were not worse in the hybrid group than conventional group. In the evaluation at 2 weeks after surgery, the knee extension muscle strength and 6MD values significantly decreased compared with the preoperative values only in the conventional group.
CONCLUSION
Lower limb muscular strength and endurance were maintained in the hybrid group, which suggested that hybrid physiotherapy could maintain physical functions early after THA operation.

Keyword

Anti-gravity treadmill; Low frequency electrical stimulation device; Hip osteoarthritis; Total hip arthroplasty

MeSH Terms

Arthroplasty, Replacement, Hip*
Electric Stimulation
Follow-Up Studies*
Humans
Knee
Knee Joint
Lower Extremity
Muscle Strength
Osteoarthritis, Hip
Outcome Assessment (Health Care)
Rehabilitation
Retrospective Studies
Walking

Figure

• 

  Fig. 1. Conventional postoperative rehabilitation protocol for total hip arthroplasty operation in Hiroshima University Hospital. From one day after surgery, it is permitted for the patient to begin a range-of-motion exercise, muscle strength training on the operated side, and walking exercise with a walker. During this timeframe, a T-cane walking exercise is permitted from the 7th postoperative day. It is noted that only hip joint rotation and bridging are prohibited postoperatively during the hospitalization.

• 

  Fig. 2. New physical therapy equipment. (A) Anti-gravity treadmill. On the anti-gravity treadmill, especially AlterG (Alter-G Corp., Fremont, CA, USA), the load on the lower extremities can be adjusted every 1% within the range of 20%–100%. (B) Belt electrode type skeletal muscle electrical stimulation (B-SES). In AUTO TENS PRO (Homer Ion Corp., Tokyo, Japan), all the belts are electrodes. It is known as a new electrical stimulation device that allows electricity to flow through the entire lower limb in a tube state, and moves all of the muscles of the lower limbs by wrapping the belt around the legs.

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