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Abstract of Higher Degree Thesis An Investigation into the Sit-stand-sit Activity in Normal Subiects and Patients with Total HiD Rerdacement

Kate Kerr P ~ D MW

Course: Doctor of Philosophy, Queen’s University of Belfaet, 1995

Housed at: Queen’s University of Belfast, department of orthopaedic surgery, and University library

A measurement system was developed conaiding of vector stereography, accelerometry and electro- goniometry, to analyee the sit-stand-sit movement activity in normal subjects and patients admitted for total hip replacement. Data derived from the measurement system were passed through a seven- channel amplifier and recorded using an analogue to digital converter on a computer. The validity, accuracy and repeatability of individual elements of the system were established, and the reliability of the system as a whole, when applied in repeated trials within a single subject, demonstrated coefficients of variance of less than 5% over a number of spatial and temporal parameters extracted from the data.

A definitive hmework for the analysis of the sit-stand- sit movement cycle was proposed, based on events identified from the spatial and temporal data. The movement cycle was defined in terms of phases (rising and descending), eomponenta (forward lean, vertical displacement, knee angular displacement and recovery) and events, based on changes in displacement parameters. Within this definitive h e m o r k statistical analysis of numerical data extracted from the recorded movement patterns was carried out on a number d specifk temporal and spatial parametem to determine both abaolute values, and temporal relatiomhip between phaeee, components and events.

Data derived from 50 normal healthy subjecta, 25 men

and 25 women, aged between 20.1 and 78.3 yeam (mean age 46.8) were a n a l w to provide normative data for the sit-stand-sit movement cycle, and to identify where differences existed in the selected parametem due to BB. and age In general, there was consistency in the pattern ofaseociationbetweenthephaaes,componeutsandwents both within individual groups and within the tdal combined group, and where Merencee emerged among groups, these tended to involve the elderly groups, and occur during the rising phaee of the cycle Data from a total of 30 patients, 17 women and 13 men, aged between 35.0 and 79.3 years (mean age 65.5 m) admitted for total hip replacement were analysed during the sibstand-sit movement cycle, prior to surgery. Eleven women and 12 men performed the activity in a manner similar to the normal pattern of movement, with a general trend towards slower movement times than those exhibited by normal subjecta Two alternative compensatory strategies were demonetrated by the remaining patients, namely a ‘slow ridslow descent’ strategy, and a ‘multiple attempts’ strategy. Fourteen af these patients were re-analyeed six weehe after surgery, of whom 11 performed the movement in a manner similar to the normal pattern, and temporal parametem approached values from normal subjects. The remaining three subjects again demonstrated the same compensatory strategies.

Compariaona between the findings ofthis study and those from previous studies were made, and explanationa for findings propoeed. It was generally concluded that the meaeurement eyrhem developed in thie study was capable of providing accurate and reliable information on the sib stand-sit movement cycle, and that the definitive framework propod enabled a stan- approach to the analysis of the movement activity in normal aubjecte and thoae with pathology affecting the lower limb. Recommendations for further research were made.