A novel tool for continuous fracture aftercare – Clinical feasibility and first results of a new telemetric gait analysis insole

Braun, Benedikt J.; Bushuven, Eva; Hell, R; Veith, Nils T.; Buschbaum, Jan; Holstein, Joerg H.; Pohlemann, Tim

doi:10.1016/j.injury.2015.11.004

Cited by 46 publications

(39 citation statements)

References 24 publications

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“…The average Peakforce applied to the fractured side is significantly lower on the affected side than on the contralateral. Similar findings were described in previous studies using load measuring insoles to detect the plantar force in lower limb fractures [16,17,25]. To the best of our knowledge the present study is the first to investigate the use of a mobile insole sensor in fragility fractures of the pelvis.…”

Section: Discussionsupporting

confidence: 86%

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Load-Bearing Detection with Insole-Force Sensors Provides New Treatment Insights in Fragility Fractures of the Pelvis

Pfeufer

Becker

Faust

et al. 2020

JCM

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Background: Due to an aging society, more and more surgeons are confronted with fragility fractures of the pelvis (FFPs). The aim of treatment of such patients should be the quickest possible mobilization with full weight-bearing. Up to now however, there are no data on loading of the lower extremities in patients suffering FFPs. We hypothesized to find differences in loading of the lower limbs. Methods: 22 patients with a mean age of 84.1 years were included. During gait analysis with insole-force sensors, loading on the lower extremities was recorded during early mobilization after index fracture. Results: Especially the average peak force showed differences in loading, as the affected limb was loaded significantly less {59.78% (SD ± 16.15%) of the bodyweight vs. 73.22% (SD ± 14.84%) (p = <0.001, effect size r = 0.58)}. Furthermore, differences in loading in between the fracture patterns of FFPs were observed. Conclusion: This study shows that it is possible to reliably detect the extremity load, with the help of an insole device, in patients presenting with fragility fractures of the pelvis. There is great potential to improve the choice and time of treatment with insole-force sensors in FFPs in future.

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Section: Discussionsupporting

confidence: 86%

“…Thus, wearable insoles offer a novel and unique technology to gather metrics of gait in a potentially more clinically relevant way [14,15]. Wearable insoles have been used in different situations, such as aftercare of hip fracture patients [16,17] to measure weight-bearing and collect gait analysis data in elderly patients.…”

Section: Introductionmentioning

confidence: 99%

Load-Bearing Detection with Insole-Force Sensors Provides New Treatment Insights in Fragility Fractures of the Pelvis

Pfeufer

Becker

Faust

et al. 2020

JCM

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“…Also, this method is not suitable when a patient is wearing an orthosis, owing to the difficulty of marker placement on bony landmarks. Different types of insoles showed good reliability and validity among healthy as well as injured subjects, 5,6,14 and wireless insoles may be a useful tool for evaluating forces during gait. Sandberg et al 26 used an insole device to measure plantar flexion moments and found that patients after ATR repair were not activating the calf muscles during gait in an orthosis.…”

Section: Discussionmentioning

confidence: 93%

High Plantar Force Loading After Achilles Tendon Rupture Repair With Early Functional Mobilization

et al. 2019

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Background: Mechanical loading is essential for tendon healing and may explain variability in patient outcomes after Achilles tendon rupture (ATR) repair. However, there is no consensus regarding the optimal postoperative regimen, and the actual amount of loading during orthosis immobilization is unknown. Purpose: The primary aim of this study was to assess the number of steps and the amount of loading in a weightbearing orthosis during the first 6 weeks after surgical ATR repair. A secondary purpose was to investigate if the amount of loading was correlated to fear of movement and/or experience of pain. Study Design: Case series; Level of evidence, 4. Methods: Thirty-four patients (mean ± SD age, 38.8 ± 8.7 years) with ATR repair were included. Early functional mobilization was allowed postoperatively in an orthosis with adjustable ankle range of motion. During the first postoperative 2 weeks, patient-reported loading and pain were assessed with a visual analog scale and step counts with a pedometer. At the 2- and 6-week follow-up, a mobile force sensor was used for measuring plantar force loading, and the Tampa Scale for Kinesiophobia was used to examine fear of movement. Results: Between the first and second weeks, there was a significant increase in the mean number of daily steps taken (from 2025 to 2753, P < .001) as well as an increase in self-reported loading (from 20% to 53%, P < .001). Patient self-reported loading was significantly associated with the plantar force measurement (rho = 0.719, P < .001). At 6 weeks, loading was 88.2% on the injured limb versus the uninjured limb. Fear of movement was not correlated with pedometer data, subjective loading, pain, or force data. Patients with less pain during activity, however, reported significantly higher subjective load and took more steps (P < .05). Conclusion: This is the first study to demonstrate the actual loading patterns during postoperative functional mobilization among patients with surgically repaired ATR. The quick improvements in loading magnitude and frequency observed may reflect improved tendon loading essential for healing. Pain, rather than fear of movement, was associated with the high variability in loading parameters. The data of this study may be used to improve ATR rehabilitation protocols for future studies. Registration: NCT02318472 (ClinicalTrials.gov).

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“…Despite a paucity of data on patient ambulation during recovery outside of a clinical setting, our findings are similar to the most current results in the literature. While Braun et al 23 only performed measurements for a total of six weeks, they also observed that the average time spent active by a group of 10 ankle fracture patients increased overtime and that there was a relatively large standard deviation in the time spent active. Time spent active may include ambulation by both the healthy limb and the injured limb.…”

Section: Discussionmentioning

confidence: 99%

“…An exception is the OpenGo insole which measures the amount of active time spent by ankle fracture patients for a duration of six weeks. 23 It is unclear, however, if the amount of time spent active, refers to dynamic or static activities. Activity monitors that are designed for consumer fitness and wellness tracking have also been used to quantify ambulation with varying results.…”

Section: Introductionmentioning

confidence: 99%

Development of a step counting algorithm using the ambulatory tibia load analysis system for tibia fracture patients

Lajevardi-Khosh

Tresco

Stuart

et al. 2018

Journal of Rehabilitation and Assistive Technologies Engineerin

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Introduction : Ambulation can be used to monitor the healing of lower extremity fractures. However, the ambulatory behavior of tibia fracture patients remains unknown due to an inability to continuously quantify ambulation outside of the clinic. The goal of this study was to design and validate an algorithm to assess ambulation in tibia fracture patients using the ambulatory tibial load analysis system during recovery, outside of the clinic. Methods Data were collected from a cyclic tester, 14 healthy volunteers performing a 2-min walk test on the treadmill, and 10 tibia fracture patients who wore the ambulatory tibial load analysis system during recovery. Results The algorithm accurately detected 2000/2000 steps from simulated ambulatory data. During the 2-min walk test, step counts derived from the algorithm and treadmill showed a strong correlation (r 2 >0.98) to the visual (“actual”) step count. Applying the algorithm to continuous data from tibia fracture patients revealed qualitative differences in gait between the initial and later stages of recovery. Additionally, a relatively large standard deviation (≤3000 steps) in the daily average step count indicated a variety of patient ambulatory behaviors. Conclusion The algorithm reported in this study can assess the ambulatory activity of tibia fracture patients during the recovery period.

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A novel tool for continuous fracture aftercare – Clinical feasibility and first results of a new telemetric gait analysis insole

Cited by 46 publications

References 24 publications

Load-Bearing Detection with Insole-Force Sensors Provides New Treatment Insights in Fragility Fractures of the Pelvis

Load-Bearing Detection with Insole-Force Sensors Provides New Treatment Insights in Fragility Fractures of the Pelvis

High Plantar Force Loading After Achilles Tendon Rupture Repair With Early Functional Mobilization

Development of a step counting algorithm using the ambulatory tibia load analysis system for tibia fracture patients

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