This study aimed to investigate the factors affecting walking independence at discharge in patients who were independently ambulant before THA.
This study included 88 patients (73 women, mean age 68.9±8.9 years, BMI 23.7±3.4 kg/m², length of hospital stay 19.2±3.2 days) who underwent THA (posterior approach) for osteoarthritis at our hospital between 2021 and 2023. Patient assessment included baseline characteristics (gender, age, and BMI), physical performance measures including walking speed (10-meter walk test [10MWT], Timed Up and Go Test [TUG]), manual muscle testing (MMT) for hip flexion, extension, and abduction, and range of motion (ROM) for hip flexion, extension, and abduction, and pain intensity (Numeric Rating Scale [NRS]; at rest and during walking). Walking speed was assessed preoperatively, and at 1 and 2 weeks postoperatively. MMT, ROM, and NRS were measured preoperatively and at discharge. Patients were classified into two groups based on walking independence at discharge: the independent walking group and the T-cane group. Group comparisons were conducted using the Mann-Whitney U test and χ² test. Statistical analysis was performed with SPSS Statistics 20, with significance defined as p0.05.
There were 64 patients in the independent walking group (52 women, mean age 69.3±8.4 years, BMI 23.5±3.8 kg/m², hospital stay 18.8±2.7 days) and 24 patients in the T-cane group (21 women, mean age 67.8±10.0 years, BMI 24.4±2.2 kg/m², hospital stay 20.4±4.0 days). No significant differences were found in baseline characteristics between the two groups. However, significant differences were observed in the 10MWT at 2 weeks postoperatively, with the independent and T-cane groups showing speeds of 8.6±1.5 s and 10.9±2.9 s, respectively. In the TUG, the independent group demonstrated significantly faster times at both 1 week (12.8±3.7 s) and 2 weeks postoperatively (9.7±2.0 s), compared to the T-cane group (16.2±6.9 s at 1 week and 12.5±2.9 s at 2 weeks). Additionally, hip extension ROM at discharge was significantly greater in the independent group, with a median of 5° (0–10°), whereas the T-cane group had a median of 0° (0–5°). No significant differences were observed between the two groups in terms of hip muscle strength and pain intensity before surgery and at discharge.
This study suggests that postoperative walking speed (10MWT, TUG) and hip extension ROM are associated with gait patterns at discharge in THA patients. Early postoperative walking speed may indicate discharge walking independence, while improving hip extension ROM may enhance gait patterns at discharge.
Early postoperative walking speed and hip extension ROM can be useful indicators for predicting walking independence at discharge in THA patients. Focusing on these factors during rehabilitation may enhance patient outcomes.
Gait patterns
Walking speed
