OBJECTIVE To determine the influence of cognitive functioning on gait recovery after total hip arthroplasty. DESIGN Prospective cohort study. SETTING Rehabilitation hospital. PARTICIPANTS 40 patients who underwent a total hip arthroplasty, with normal cognitive functioning and without any other relevant medical condition were recruited and studied before surgery and at the beginning and the end of the rehabilitation program. MAIN OUTCOME MEASURES Gait speed (10-Meter Walk Test, 10MWT) and functional mobility (Timed Up and Go test, TUG), measured at the time of discharge from the rehabilitation unit, were the primary outcomes. The candidate predictors were the cognitive and psychological variables collected in the pre-surgery phase, together with other potentially informative measures such as age, education, perceived pain, body mass index, pre-surgical gait speed and functional mobility. RESULTS The results suggest the existence of a direct relationship between cognitive functioning, with specific reference to high-level frontal executive functions, and the post-operative progress: the better the cognitive functioning in the pre-operative phase, the better the course of recovery in terms of gait speed and functional mobility. In particular, the performance at the Frontal Assessment Battery test, together with age, perceived pain and pre-surgical gait speed/functional mobility was the best predictor of recovery of walking measured by 10MWT and TUG. CONCLUSIONS The present study highlights the importance of cognitive functioning, together with clinical and demographic features, in the post-surgical recovery of walking, even in the absence of cognitive decline.In particular, these data show the crucial role of higher-order cognitive processes, such as executive functions, involved in the formulation of motor plans and their integration with proprioceptive and visual cues.

中文翻译：

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认知执行功能在全髋关节置换术后步态恢复中的重要性

目的探讨认知功能对全髋关节置换术后步态恢复的影响。设计前瞻性队列研究。设置康复医院。参与者 40 名接受全髋关节置换术、认知功能正常且无任何其他相关医疗条件的患者在手术前、康复计划开始和结束时被招募和研究。主要结果测量步态速度（10 米步行测试，10MWT）和功能活动性（定时起跳测试，TUG），在康复单位出院时测量，是主要结果。候选预测因子是在术前阶段收集的认知和心理变量，以及其他潜在的信息量度，如年龄、教育、感知疼痛、体重指数、术前步态速度和功能活动性。结果 结果表明，认知功能（特别是高级额叶执行功能）与术后进展之间存在直接关系：术前阶段的认知功能越好，恢复过程越好在步态速度和功能移动性方面。特别是，在正面评估电池测试中的表现，连同年龄、感知到的疼痛和术前步态速度/功能活动性，是通过 10MWT 和 TUG 测量的步行恢复的最佳预测指标。结论 本研究强调了认知功能以及临床和人口统计学特征在术后步行恢复中的重要性，即使在没有认知能力下降的情况下也是如此。