Methodology of gait assessment for identifying mechanisms of decompensatory musculoskeletal fatigue in patients with hip arthritis

Introduction Gait analysis is an objective tool for assessing treatment results and musculoskeletal function in patients with orthopedic pathology. Safety of compensatory mechanisms and the fatigue component seen with repeated measurements and being dependent on the clinical situation are essential for the patients. The objective was to develop a methodology of gait assessment for identifying mechanisms of decompensatory musculoskeletal fatigue in patients with hip arthritis including those with THA of the contralateral limb. Material and methods The study included 41 patients with Kellgren – Lawrence grade III and IV hips. Gait analysis was performed using the Stedis-Step treadmill and five Neurosens inertial sensors (Neurosoft LLC, Ivanovo, Russia), recording the spatiotemporal and kinematic characteristics of movements in the lumbosacral spine, hip and knee joints being synchronized with the step cycle. Patients were divided into two groups according to gait assessment protocol including Group 1 (n = 26) with three series of two minute tests with a break of at least 20 minutes; Group 2 (n = 15) with three series of two-minute walks without a break with the total length of six minutes. Results A 20-minute rest was enough to reproduce baseline gait parameters. Walking parameters including maximum flexion phase, stance period and range of motion could serve as markers for early detection of mechanisms of decompensatory muscle fatigue. The total hip arthroplasty on the contralateral side significantly affected the gait parameters. Discussion New methods of no-break gait assessment facilitated decompensation and fatigue mechanisms identified in patients with hip arthritis. Reduced movement amplitude during short-term load indicated increasing fatigue even over a brief period (6 minutes). Conclusion The methodology allowed for the identification of mechanisms of decompensatory musculoskeletal fatigue in patients with hip arthritis including those with THA of the contralateral limb, early diagnosis, improved monitoring and rehabilitation.