Abstract
Objective
To determine the influence of cognitive functioning on gait recovery after total hip
arthroplasty.
Design
Prospective cohort study.
Setting
Rehabilitation hospital.
Participants
Patients (N=40) who underwent a total hip arthroplasty, with normal cognitive functioning
and without any other relevant medical condition, were recruited and studied before
surgery and at the beginning and the end of the rehabilitation program.
Main Outcome Measures
Gait speed (10-Meter Walk Test [10MWT]) and gait functional mobility (Timed Up and
Go [TUG] test), measured at the time of discharge from the rehabilitation unit, were
the primary outcomes. The candidate predictors were the cognitive and psychological
variables collected in the presurgery phase, together with other potentially informative
measures such as age, education, perceived pain, body mass index, presurgical gait
speed and functional mobility.
Results
Our results suggest the existence of a direct relationship between cognitive functioning,
with specific reference to high-level frontal executive functions, and the postoperative
gait progress: the better the cognitive functioning in the preoperative phase, the
better the course of recovery in terms of gait speed and functional mobility.
In particular, the performance of the Frontal Assessment Battery test, together with
age, perceived pain. Presurgical gait speed and functional mobility, was the best
predictor of recovery of walking measured by 10MWT and TUG.
Conclusions
The present study highlights the importance of cognitive functioning, together with
clinical and demographic features, in the postsurgical recovery of walking, even in
the absence of cognitive decline.
In particular, these data show the crucial role of higher-order cognitive processes,
such as executive functions, involved in the formulation of motor plans and their
integration with proprioceptive and visual cues.
Keywords
List of abbreviations:
10MWT (10-Meter Walk Test), AIC (Akaike information criterion), BDI (Beck Depression Inventory), DSB (Digit Span Backward), FAB (Frontal Assessment Battery), MMSE (Mini-Mental State Examination), STAI-X (State-Trait Anxiety Inventory), THA (total hip arthroplasty), TUG (timed Up and Go), VAS (visual analog scales)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: January 06, 2020
Footnotes
Supported by the Italian Ministry of Health (Ricerca Corrente; project no. L3031 ; PI: L.Z.).
Clinical Trial Registration No.: NCT03624998.
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
