Is it possible to train patients to limit weight bearing on a lower extremity?
Orthopedic patients are often instructed on how much weight to bear on an injured or postoperative extremity. Although specific weight-bearing instructions are given to a majority of lower-extremity orthopedic patients, the ability of patients to comply with these instructions is questioned in the medical literature. This study compared the effectiveness of new forms of clinical interventions designed to train patients on weight bearing, focusing on the use of biofeedback devices designed to offer real-time feedback to partial weight-bearing patients. Twenty healthy patients aged 20 to 30 years completed 3 interventions: (1) verbal instructions on weight bearing, (2) training with a bathroom scale, and (3) training with a biofeedback device.Patients given touchdown weight-bearing instructions (25 lb) initially bore an average of 63.57±6.24 lb when given verbal instructions. This was reduced to 44.75±5.69 lb after training with a bathroom scale (P<.001), and was further reduced to 26.2±1.57 lb with biofeedback training (P=.011). Likewise, patients given partial weight-bearing instructions (75 lb) initially bore an average of 92.28±7.85 lb. No improvement occurred with the use of a bathroom scale (at 75 lb), which showed an average of 90.82±7.19 lb (P=1.000). Training with a biofeedback device improved the average weight bearing to 69.67±3.18 lb (P=.014).Biofeedback training led to superior compliance with touchdown and partial weight-bearing instructions. Because partial weight-bearing instructions are commonly given to orthopedic patients, training with such a device may be appropriately considered.
Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut 06520, USA.
Joshua W
JW
Hustedt
Daniel J
DJ
Blizzard
Michael R
MR
Baumgaertner
Michael P
MP
Leslie
Jonathan N
JN
Grauer
D000328:Adult; D001676:Biofeedback, Psychology / Q000379:methods* / Q000502:physiology*; D005260:Female; D006801:Humans; D007866:Leg / Q000502:physiology*; D008297:Male; D026741:Physical Therapy Modalities; D004856:Postural Balance / Q000502:physiology*; D011187:Posture / Q000502:physiology; D013647:Task Performance and Analysis; D016474:Weight-Bearing / Q000502:physiology*; D055815:Young Adult