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Static and dynamic postural balance after successful mobile-bearing total ankle arthroplasty
Keun Bae Lee1, Young Hoon Park, Eun Kyoo Song
1Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, Gwangju 501-757, South Korea. kbleeos@chonnam.ac.kr
Objective:
To investigate static and dynamic postural balance after successful total ankle arthroplasty by using dynamic posturography.
Design:
A controlled trial study.
Setting:
A national university orthopedic and rehabilitation hospital.
Participants:
Patients (n=30, 21 men, 9 women; mean age, 58y) and age- and sex-matched healthy controls (n=30).
Interventions:
Thirty patients who underwent unilateral total ankle arthroplasty with a cementless mobile-bearing ankle prosthesis and 30 age- and sex-matched healthy control subjects were included.
Main Outcome Measures:
Using computerized dynamic posturography, sensory (sensory organization test [SOT]), and motor (limit of stability [LOS], rhythmic weight shift [RWS], and weight bearing) impairment assessments were performed at an average of 15 months after total ankle arthroplasty.
Results:
In the SOT, results of the SOT-2 test reflecting mainly proprioception showed no significant difference between patients and controls, but patients demonstrated significantly lower scores for SOT-4, -5, and -6 as a measure of dynamic postural balance and required more hip movement to maintain balance. In the motor-control tests, patients showed significantly lower measures in indices of LOS test except the mean reaction time and the forward/backward directional control and on-axis velocity of the RWS test. Weight bearing was observed asymmetrically in patients.
Conclusions:
Patients had a higher degree of dynamic postural imbalance and relied less on ankle strategy to maintain balance than controls. Also, patients showed the deficit of motor control ability as compared with age- and sex-matched healthy controls.
