The influence of the crutch setup on stability and weight-bearing parameters in post total hip replacement surgery patients during quiet standing.
PURPOSE
The purpose of this study is to evaluate the influence of the crutch setup on standing, in post total hip replacement (THR) surgery patients.


MATERIALS AND METHODS
Thirty patients after THR were randomly assigned to walking with the elbow flexed (EF) or elbow straight (ES) crutch setup. Subjects were asked to stand on a force platform in a comfortable position with the crutch positioned on the unaffected side, facing forward for 10 seconds. Centre of pressure total path and maximal excursion were evaluated in both medio-lateral and anterior-posterior planes. Difference in the asymmetry of left/right acromial height, measured with and without the crutch, was calculated (ACdiff). Percentage of body weight borne by the crutch (Fcr), symmetry (SIload) between operated and healthy limbs loading during the trial, together with shoulder forces and moments were measured.


RESULTS
No significant differences between the two groups (p > .05) were found for stability parameters. ACdiff, Fcr and shoulder load increased significantly (p < .05) in EF group compared to ES group. In addition leg loading symmetry was significantly reduced in the EF group.


CONCLUSIONS
The present study showed that the ES setup reduced the force borne by the crutch, the load on the shoulder joint and it minimized postural and loading asymmetries when compared to EF setup. Conversely, postural stability was not influenced by the crutch setup. Implications for Rehabilitation Static posture and weight-bearing parameters are influenced by crutch setup during quiet standing. Crutch setup does not influence postural stability. Adjusting the crutch according to the elbow straight setup reduces the force borne by the crutch and the asymmetry in lower limbs loading. Forces and moments at the shoulder joint were reduced for the elbow straight setup group.
['Esposito|Francesco|F|', 'Freddolini|Marco|M|http://orcid.org/0000-0002-8649-494X', 'Latella|Leonardo|L|', 'Braccio|Palmina|P|', 'Marcucci|Massimiliano|M|', 'Corvi|Andrea|A|']
D000368:Aged D019644:Arthroplasty, Replacement, Hip D001696:Biomechanical Phenomena D001835:Body Weight D003446:Crutches D004867:Equipment Design D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D004856:Postural Balance D011187:Posture D016474:Weight-Bearing
Crutch setup weight-bearing total hip replacement postural stability rehabilitation