Browsing by Author "Leigh, Ryan"
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Item Open Access Movement Biomechanics and Personalized Exercise Interventions in Individuals with Hip Osteoarthritis(2016) Leigh, Ryan; Ferber, Reed; Dukelow, Sean; Culos-Reed, Nicole; Duffett-Leger, LindaHip osteoarthritis (OA) is a prevalent musculoskeletal disorder that results in increased patient morbidity and dysfunction. While exercise is a common therapeutic modality employed in the management of this disorder, effect sizes remain small. Given this finding, the overarching aim of this thesis was to better understand the 3-dimensioanl (3D) gait biomechanics of this clinical population and subsequently test novel exercise interventions to improve clinical outcomes in individuals with mild-to-moderate hip OA. Following the Introduction, Chapter 2 explored whether tester experience influenced the reliability with which 3D gait data can be collected. This study was important since 3D gait collections would be a major part of the final two chapters. Using a coefficient of multiple correlation (CMC) statistic to estimate within-tester reliability, we found that within-tester CMC values exceeded 0.90 for both novice and experienced testers across all kinematic variables. Chapter 3 summarized the current hip OA and exercise literature and determined whether land-based exercise is an effective intervention in hip OA subjects not awaiting surgery. Pooled data from 7 studies demonstrated exercise had no effect on pain or self-reported function immediately post intervention and the overall effect sizes remained small. Chapter 4 characterized the 3D kinematic gait patterns of individuals with mild-to-moderate hip OA considering that to this point, the lower extremity kinematics of hip OA patients had not been fully described. We reported that hip OA subjects walked with greater peak hip abduction, reduced peak hip extension, and greater peak hip external rotation compared to age and body mass index (BMI) matched healthy controls. Whether these subtle biomechanical abnormalities could be used as treatment targets was explored in the capstone investigation. In Chapter 5, we targeted these 3D gait abnormalities with a novel tailored exercise intervention in mild-to-moderate hip OA subjects. This exercise protocol was compared to a tailored intervention that was based on a standard clinical assessment. No significant improvements in pain were found across either group at 8-weeks follow-up and a 3D gait derived exercise program did not result in improved clinical outcomes.