Authors: Pishtiwan H. S. Kalmet 
Maxima Medical Center, Veldhoven, the Netherlands



Partial or permissive weight-bearing is often prescribed by surgeons to patients who have undergone surgery for fractures in the lower extremities. Compliance with these weight-bearing instructions is crucial for successful postoperative rehabilitation. The use of biofeedback devices like ComeBack Mobility crutches (CBM) has shown promise in improving patient compliance. However, the usability of the device must be tested from the perspective of both the physical therapists and patients for successful implementation.

Additionally, a recent retrospective cohort study found that weight bearing after surgically treated tibial plateau fractures is safe and can lead to a significantly reduced time to full weight bearing without significant differences in patient-reported quality of life, pain, or complication rates.


This study utilized a convergent mixed-methods design to collect qualitative and quantitative data on the usability of CBM crutches from the perspective of physical therapists and patients. Usability was measured in terms of user performance, satisfaction, and acceptability. Patients and their physical therapists were asked to use CBM crutches during postoperative rehabilitation, and usability was tested qualitatively through a think-aloud method and a semi-structured interview, as well as quantitatively through the System-Usability-Scale (SUS) and closed questions.


32 patients and 12 physical therapists participated in the study. The mean SUS scores for patients and physical therapists for the CBM crutches were 75 and 65, respectively. The qualitative data showed mixed views and perceptions from patients and physical therapists on satisfaction and acceptability. Patients took an average of 6.3 minutes to adapt to the prescribed weight-bearing with CBM crutches.


Overall, the usability of the CBM crutches was found to be acceptable from the perspective of both physical therapists and patients. This study provides insight into the usability of CBM crutches for providing feedback on weight-bearing during postoperative rehabilitation. CBM crutches have the potential to be a promising biofeedback tool for postoperative rehabilitation.

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