Abstract
Introduction
Climbing up and down stairs with crutches is a particular challenge. The current study evaluates a commercially available insole orthosis device for weighing an affected limb and for biofeedback training of gait. This study was done on healthy, asymptomatic individuals before applying to the intended postoperative patient. The outcomes should demonstrate whether a continuous real-time biofeedback (BF) system is more effective on stairs than the current protocol involving a bathroom scale.
Materials and methods
59 healthy test subjects received both crutches and an orthosis and learned to apply a 3-point gait with a partial load of 20 kg using a bathroom scale. Thereafter, the participants were asked to complete an up-and-down course, first without (control group) and then with (test group) an audio-visual real-time biofeedback (BF). Compliance was evaluated using an insole pressure measurement system.
Results
Using the conventional therapy technique, 36.6% of the steps up and 39.1% of the steps down in the control group were loaded with < 20 kg. By activating continuous biofeedback, steps with < 20 kg could be increased significantly to 61.1% upstairs (p < 0.001) and 66.1% downstairs (p < 0.001). All subgroups profited from the BF system, independent of age, gender, side relieved, dominant or non-dominant side.
Conclusions
Traditional training without biofeedback led to poor performance for partial weight bearing on stairs, even among young and healthy individuals. However, continuous real-time biofeedback clearly improved compliance, indicating its potential to enhance training and support future research in patient populations.
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This data is available for independent inspection or re-evaluation at any time, given explicit permission of the Head of the Department.
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TPM and TDS researched literature and conceived the study. CK was involved in protocol development and gaining ethical approval. NH and JS and TD were involved in patient recruitment and data analysis. TPM wrote the first draft of the manuscript. All authors reviewed and edited the manuscript and approved the final version of the manuscript.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the local ethics committee of the University Tuebingen (protocol number 674/2021BO2).
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Merkle, T.P., Hofmann, N., Schmidt, J. et al. Continuous real-time biofeedback in orthosis improves partial weight bearing on stairs. Arch Orthop Trauma Surg 143, 5701–5706 (2023). https://doi.org/10.1007/s00402-023-04878-y
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DOI: https://doi.org/10.1007/s00402-023-04878-y