Work

Uncontrolled manifold analysis of center-of-mass control during gait before and after total hip arthroplasty in patients with hip osteoarthritis: a secondary analysis of a prospective cohort study

Year: 2026

Type: article

Abstract: Background Total hip arthroplasty (THA) is an effective treatment for hip osteoarthritis (HOA), and postoperative gait analysis is important for evaluating recovery and designing rehabilitation strategies. However, conventional gait assessment has focused primarily on the motion of individual joints and may not adequately capture the inter-joint coordination required to control the center of mass (CoM). Uncontrolled manifold (UCM) analysis provides a framework for quantitatively evaluating this coordination. Clarifying how gait coordination changes before and after THA may offer useful insights for rehabilitation. In this study, we used UCM analysis to examine changes in CoM control (V UCM , V ORT , ΔVz) during gait before and after THA in patients with HOA. Methods Using a publicly available gait dataset, we analyzed the gait of 53 patients with HOA before and after THA. From motion-capture data, segment angles were defined as the elemental variables and the CoM as the performance variable. V UCM , V ORT , and ΔVz were computed using UCM analysis and compared between the preoperative and postoperative time points. Results After surgery, V UCM decreased significantly in all phases, and V ORT decreased significantly in mid-stance and terminal stance (p < 0.05). In contrast, ΔVz showed no significant change in any phase (p > 0.05). The mean mediolateral CoM position and its trial-to-trial variability did not change between the preoperative and postoperative time points. Conclusions These results suggest that, even when hip function changes, the body can flexibly exploit the available degrees of freedom to stabilize the CoM. Given that CoM control is distributed across multiple segments rather than a single segment, postoperative rehabilitation may benefit from considering the coordination of the whole movement system in addition to the affected joint. Trial registration ClinicalTrials.gov, NCT01907503. Registered 17 July 2013. Retrospectively registered.

Source: BMC Musculoskeletal Disorders

DOI: 10.1186/s12891-026-10504-w

Authors: Ryuya Yamakawa, Yusuke Sakaue, Shima Okada, Naruhiro Shiozawa

Institutions: Hiroshima University, Ritsumeikan University, Hiroshima University Hospital, The University of Osaka

Language: English

Topic: Balance, Gait, and Falls Prevention

Subfield: Physical Therapy, Sports Therapy and Rehabilitation

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,090