Most patients have a hard time figuring out how much weight they are putting on the injured leg. This uncertainty comes at a price, as uncontrolled weight bearing can cause adverse health effects and prolonged rehabilitation
Protected weight bearing is prescribed after a number of surgeries, diseases and injuries to the lower extremities to reduce the risk of complications and stimulate the healing process. This is an extremely important stage, but due to various factors, most patients do not comply well with their load restrictions, as evidenced by the studies below
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In little over three weeks after surgery, more than half of the patients stopped strictly adhering to their weight bearing limitations. The non-compliance rate continued to increase and reached almost 80% by the 6th week [1]
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At the first follow-up visit, the prescribed load targets were completed by a little less than 30%. The participants reported limited confidence in the instruction efficacy [2]
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In another study, the subjects had to wear pressure sensing films before the visit: 9 in 10 patients were later found to have been overloading the injured leg [3]
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Patients over 65 seemed to struggle the most. 8 in 10 participants tended to bear significantly more weight through the injured leg, even after three weeks of daily exercise and partial weight bearing gait training with a physiotherapist [4]
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In another study, the elderly patients were found to be walking on crutches only in the presence of medical staff, but in private they preferred not to get out of bed at all to avoid excessive load on the extremity [5]
Constant excessive strain on the injured site can lead to implant failure or repeated trauma [6]
For patient stories and what complications they have encountered – here
Which patient groups are most likely to not follow load restrictions?
– Over 65
– Physically active
– With excess body weight
– Those whose postoperative pain has reduced
– Patients with neurological disorders (e.g. sensory loss in diabetes)
– Patients with decreased proprioception (the sense of body position in space)
– Patients with a strong psychological desire to “test” the involved leg
Therefore, most patients find it difficult to estimate the amount of load they are transferring to the injured leg, which results in low weight bearing compliance levels – especially in outpatient treatment. The out-of-hospital environment and lack of direct supervision and accountability do not motivate the patient to follow weight bearing guidelines
The lack of affordable and effective tools for load control further complicates the situation
– A bathroom scale is not useful for dynamic measurements
– The hand-under-foot method is pure guessing at best
– Force plates offer better accuracy than a bathroom scale but are primarily used in clinical settings due to high purchase and maintenance costs [7]
– Most biofeedback devices have shown great results in the dynamic situation but, just like the force plates, are too expensive for private purchase [8, 9]
Is there a better and more affordable way to help patients follow weight bearing guidelines and facilitate recovery?
ComeBack Mobility offers a solution that allows for high accuracy, low cost and home use!
Our smart crutch tips with built-in force sensors and a mobile app help monitor weight bearing in a dynamic situation and provide real-time audiovisual feedback in case of non-compliance
Attach them in minutes, walk for miles and let the smart crutch tips tell you what to do. Download our app and monitor the progress of rehabilitation as you go
How Does It Work?
The patient applies load to the injured leg as prescribed by their attending physician. In case of non-compliance, they receive instant notifications from the devices
Data about patient’s weight bearing status, compliance, daily steps, and concerns are sent to the physician’s phone or PC
The doctor monitors how the patient loads the involved leg and adjusts the weight bearing status if necessary
SOURCES
- Patient compliance with touchdown weight bearing after microfracture treatment of talar osteochondral lesions
- Patient compliance with postoperative lower extremity touch-down weight-bearing orders at a level I academic trauma center
- (PDF) Weight Bearing Compliance after Foot and Ankle Surgery
- Factors Affecting Compliance With Weight-Bearing Restriction and the Amount of Weight-Bearing in the Elderly With Femur or Pelvic Fractures
- Application Of Calculating The Maximum Permissible Load On The Femur After Osteosynthesis
- Current advances in training orthopaedic patients to comply with PWB instructions
- Force Plates – Do you need one?
- Different in-shoe devices for partial weight bearing
- Effectiveness of a Simple Auditory Feedback Insole
