Gait rehabilitation: a new biofeedback device for monitoring and enhancing weight-bearing over the affected lower limb.
OBJECTIVE
Gait rehabilitation programs often require either partial weight-bearing (PWB) or encourage full weight-bearing (FWB) on the affected limb. Until recently, there was no objective and practical way to measure correct weight-bearing during ambulation. The present study evaluates a new in-shoe device (SmartStep, Andante Medical Devices Ltd.) for measuring the amount of weight on the affected limb and for biofeedback gait training.


METHODS
The first part of the study aimed to establish the validity of the SmartStep by comparing the results obtained from this device with the results obtained from a force plate. The second part aimed to evaluate the effectiveness of the SmartStep as a biofeedback method in patients who have been referred for FWB gait rehabilitation. Analysis was based on independent samples t-test and chi squared test for evaluating statistically significant differences between the 2 gait rehabilitation modes.


RESULTS
The SmartStep could repeat the same results with 0.53 kg error of mean. Statistically significant correlation was found between results obtained from the SmartStep and from the force plate (R2=0.9067 and P=0.004). The use of the SmartStep auditory biofeedback, significantly (P=0.00031) improved patients' weight-bearing over the affected limb in the experimental group (7.9 kg +/-5.28) as compared to the control group (0.7+/-2.41 kg).


CONCLUSIONS
The SmartStep proved to be very reliable since it generated significant repeatable results which correlated significantly with those obtained from a force plate. Patients recommended for FWB gait can significantly improve body weight loading over the affected limb by the use of the SmartStep auditory biofeedback.
Isakov
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Kinesiology Laboratory, Orthopedic Rehabilitation Department, Loewenstein Hospital, Sackler Faculty of Medicine, Tel Aviv University, Ra'anana, Israel. elii@clalit.org.il
D000368:Aged; D000369:Aged, 80 and over; D000674:Amputees / Q000534:rehabilitation*; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D001676:Biofeedback, Psychology / Q000295:instrumentation*; D005069:Evaluation Studies as Topic; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods; D005260:Female; D005264:Femoral Fractures / Q000534:rehabilitation*; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D009069:Movement Disorders / Q000534:rehabilitation*; D009983:Orthopedic Equipment / Q000592:standards; D015203:Reproducibility of Results; D016138:Walking / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology