Contralateral and ipsilateral cane usage by patients with total knee or hip replacement

Area of Science:

• Biomechanics
• Orthopedics
• Rehabilitation Engineering

Background:

• Gait impairments are common after hip and knee replacements.
• Cane use is a common assistive strategy to improve mobility.
• The biomechanical effects of ipsilateral versus contralateral cane use on gait are not fully understood.

Purpose of the Study:

• To investigate the effects of ipsilateral (IP) and contralateral (C) cane use on gait parameters in individuals with hip or knee replacements.
• To analyze forces exerted on the cane and floor reaction forces during walking.
• To assess joint motion and temporal-spatial gait characteristics.

Main Methods:

• Four male subjects (one post-total hip replacement, three post-total knee replacement) participated.
• Axial forces on an instrumented cane and floor reaction forces from a force shoe system were measured.
• Sagittal plane motion pictures recorded cadence, stride length, velocity, and joint motion.

Main Results:

• Contralateral cane use led to greater mean stride length, increased cadence, and faster mean velocity in most subjects.
• Ipsilateral cane use resulted in greater mean knee joint motion and reduced mean hip joint motion.
• Mean peak vertical floor reaction forces were higher with ipsilateral cane use.

Conclusions:

• Contralateral cane use appears to enhance overall gait velocity and efficiency.
• Ipsilateral cane use significantly alters lower extremity joint kinematics and forces, potentially offering different support mechanisms.
• Understanding these biomechanical differences is crucial for optimizing assistive device prescription for patients with lower limb joint replacements.