EFFECT OF USING CANE ON SOME GAIT PARAMETERS FOR OSTEOARTHRITIC HIP PATIENTS BY: HAYA ALMAAWI

INTRODUCTION: The hip joint is the most important joint of the lower limb as it is the most proximal joint that provides stability The hip joint is the second link in the chain of weight transfer from the trunk to the ground. The hip joint distributes body weight and contribute to smooth, efficient ambulation.

Purpose of the study:  to determine the effect of using cane contralaterally on some gait parameters in patients with unilateral hip OA.  To determine the effect of using cane ipsilaterally on some gait parameters in patients with unilateral hip OA. Study Hypothesis : There will be no significant difference between using cane contralateral or ipsilateral on some gait parameters in patients with unilateral hip OA.

OA now is one of the most prevalent disabling diseases affect the hip. It is becoming a major medical and financial concern that affects 50% of older subjects over 60 years old. Patients with hip problems tends to assume postures that diminish the force through the joint. They lean the body weight towards the affected side during walking to reduce the force upon the affected hip. Most of persons 55 years old and 80 % more than 75 years of age having radiographic evidence of the disease in at least one hip joint.

Berman, 1991 : He measured the step length and velocity for 41 patients with degenerative hip arthritis He found that, patients took shorter steps with involved limb than control subjects and demonstrated decreased velocity.

Blount,2003, reported that cane can decrease loading on joint by 30% of their body weight and the hip contact force reduced 60% of body weight with use of a cane. Yoshihiko et al., 2000 evaluates the effectiveness of walking aids such as a cane for compensating for lost function due to joint disorders. using cane enlarges the supporting area & adjusts the posture.

LITERATURE REVIEW: Watellain et al., 2001, They compared gait of 17 controls with 17 patients with early stage of OA.  There is significant compensatory mechanism  significant differences in the cadence of gait & walking speeds were 12.4% lower than the control group.  walking speed was significantly slower in  OA patients compared to controls.

Falcomer and Hayes, 1991 : Foot print :  An inexpensive & easy method of collecting gait data.  Reliably for patients with OA of lower limbs.  Provides measurements of mean walking speed, cadence, step and stride length

Material and Methods Subjects: Two groups: patients with unilateral hip O.A healthy subjects as a reference group.

Inclusion Criteria :  male and female patients  The age will be 60 years and above  Unilateral hip OA  Able to walk Exclusion Criteria:  Deformity in other joints  Subjects with walking aids  Unable to communicate  Subjects with any neuromuscular disease.

Study Variables: Pain, time, cadence, step and stride length, foot angle, and base of support

Measurements : Visual Analogue Scale (VAS):

Self administered Lequesne-Algofunctional osteoarthritis index (LISOH) :

The foot print method: A 10 meters Sheet of smooth tracing white paper A felt pad with ink placed under the subject's feet. A height adjustable cane A hand held digital stop watch to record time. Gait velocity and cadence will be calculated.