Objective assessment of crutch-assisted gait in individuals after Total Hip Arthroplasty using sensorized crutches

Movement disorders may result from musculoskeletal injuries, such as hip fractures, leading to the need for Total Hip Arthroplasty (THA). Following surgery, rehabilitation is required for restoring hip functionality. Indeed, while people are recovering, crutches are prescribed to assist gait in the first weeks after the intervention. Functional Capacity Outcomes (FCO) are adopted to assess rehabilitation sessions; however, they are subjective and affected by intra- and inter-operator variability, as clinicians evaluate them visually. Several studies have attempted to measure FCO, although the required instrumentation restricts rehabilitation sessions to laboratory settings and to static or short-distance tasks. This thesis investigates the potential of mCrutch, a pair of instrumented crutches, to objectively assess FCO in static and dynamic conditions. The objectives are extracting FCO, such as weight-bearing, crutch tilt angle, crutch-gait symmetry, and spatiotemporal parameters and evaluating patients’ adherence to prescribed instructions. Twenty THA patients were asked to stand for 30 seconds and then to perform a 10-meter Walking Test three times. Data has been acquired twice,after surgery (Baseline) and after twenty days (Follow-up). Results demonstrated that FCO can be reliably extracted, and inter-subject variability showed to be fairly high. A statistically significant difference (p < 0.05) was observed in the force applied to the Operated Limb Crutch (OLC) and Non-operated Limb Crutch (NOLC), whereas differences between static and dynamic conditions were found for the OLC. Nevertheless, this study involves an analysis only in laboratory settings; future works should test the device outdoor. Discrepancies between clinicians’ recommendations and actual crutch usage were observed. In conclusion, results found in this thesis promote the integration of instrumented assistive devices for supporting gait in THA patients and enhancing orthopedic rehabilitation.