How Accurate Is Partial Weightbearing?

Dabke, HV; Gupta, Shantanu; Holt, Catherine Avril; O'Callaghan, P. T. O.; Dent, C.

doi:10.1097/01.blo.0000127116.13377.65

Cited by 70 publications

(49 citation statements)

References 12 publications

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“…While the present study is the first to compare performance of three different target loads across a range of body weight proportions, a number of studies have shown poor compliance with lower target loads of around 20% BW (Dabke et al, 2004;Ebert et al, 2008: Grey, Grey & McClanahan, 1998Ruiz et al, 2014). The errors reported here suggest that the outcome, from crutch-assisted gait, of weight-bearing limited to 20% or 50% BW is difficult to achieve even in healthy uninjured adults.…”

Section: Discussionmentioning

confidence: 62%

“…The teaching and accuracy of reproduction of PWBPs in clinic settings is typically assessed statically using bathroom scales (Hambly et al, 2006), however, studies in both injured and uninjured subjects have led to the conclusion that PWBP reproducibility is poor (Hustedt et al, 2012). Also the teaching and assessment of PWBP adherence using this static method may not be representative of the loads going through the limbs during gait (Hustedt et al, 2012;Malviya et al 2005) Previous research has focused on the accuracy of 20% weight-bearing in early rehabilitation (Dabke at al., 2004;Gray, Gray & McClanahan, 1998;Ruiz et al, 2014) . The reproduction accuracy of higher proportions (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Are current methods of partial weight-bearing instruction accurately translating to crutch-assisted gait?

Graham

Stephens

Dietz

et al. 2016

International Journal of Therapy and Rehabilitation

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Study Design: Repeated measures, Williams crossover design. Objectives:The aim of this study was to determine the accuracy with which weight-bearing protocols (20%, 50% or 80% of body weight (BW)) could be reproduced shortly after being taught.Background: Partial weight bearing protocols (PWBPs) are commonly incorporated into hospital, clinical and field based rehabilitation (Hershko, Tauber & Carmeli, 2008), to enhance recovery, particularly in patients following cartilage surgeries. Overloading can affect healing time and the stability or integrity of the healing structure (Pauser et al., 2012), however underloading can also be detrimental as adequate weight bearing encourages the healing process, for example osteoblastic stimulation (Meadows, Bronk, Chao & Kelly, 1990). Therefore accurate reproducibility of these protocols could be considered essential to the rehabilitation process.Methods: 30 participants were taught three partial weight bearing protocols (20%, 50% and 80% BW), using bathroom scales. Participants ability to reproduce their target load for each protocol was assessed statically using bathroom scales and dynamically with a force plate using a 3point elbow crutch assisted gait. Participants were assessed 10 minutes after being taught. Errors between actual and target load during these trials was calculated. Results:Accuracy assessed with scales was comparatively good for all target loads, however dynamic trials using the force plate showed an inverse relationship between all error measures and target loads (i.e. 20% > 50% > 80% BW; all p<0.01). The peak error was double the intended load at 20%BW (95% CI: 11.9%BW, 24.1%BW). At 80%BW the peak error was not significantly different from zero. Conclusion:The static method of instruction of PWBPs, using bathroom scales, does not seem to translate accurately to dynamic motion, and therefore affects adherence to medical instruction.Practitioners should be aware of the potential errors in reproducing these loads and the potential effect on rehabilitation. These results would suggest that practitioners should be cautious when using bathroom scales to teach PWBPs and not rely on them to assess reproduction accuracy during gait. Level of evidence:Controlled laboratory study, randomized cross-over design.

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Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Are current methods of partial weight-bearing instruction accurately translating to crutch-assisted gait?

Graham

Stephens

Dietz

et al. 2016

International Journal of Therapy and Rehabilitation

View full text Add to dashboard Cite

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“…However, the practicality of partial weight bearing following surgery is a challenge to both the patient and the physiotherapist and it is not reproducible. 7 The validity of partial weight bearing regimes has been questioned. 7 Many a times, it is not successful to mobilise an elderly demented patient with non-weight bearing.…”

Section: Discussionmentioning

confidence: 99%

“…7 The validity of partial weight bearing regimes has been questioned. 7 Many a times, it is not successful to mobilise an elderly demented patient with non-weight bearing. Moreover, the whole purpose of treating with intramedullary nail is lost.…”

Section: Discussionmentioning

confidence: 99%

Three different interlocking intramedullary nails for unstable reverse oblique inter-trochanteric fractures: a bio-mechanical comparative study

et al. 2016

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Background: Biomechanical testing, intramedullary devices have proven advantageous over the extramedullary devices in the management of unstable intertrochanteric fractures. Reverse oblique type of intertrochanteric fractures are highly unstable and intramedullary nails are currently the method of internal fixation. The currently available nails seems to provide rotational, axial and angular stability, but biomechanical analysis of the strain pattern in the bone and implant in this fractures are lacking. The aim of this experimental study was to analyse the strain in three different long femoral nail-bone units under physiological loading when implanted in Saw bone model after creating a reverse oblique intertrochanteric fracture.Methods: A total of 12 sawbones were divided in to 4 equal groups. Group 1 was intact saw bones and were used as controls. Group 2, Group 3 and Group 4 were implanted with Depuy, Stryker and Synthes nails respectively after creating a reverse oblique intertrochanteric fracture. All the four groups were axially loaded with 100 N increments until physiological loads. The strain patterns were measured at the posteromedial cortex and the peak strains were extracted at partial weight bearing i.e. 500 N and full weight bearing physiological loads i.e. 1000 N.Results: There was no significant difference in peak strains among the groups at partial loads. However at 1000 N loads the peak strain in the DePuy nail-bone unit was significantly high compared to the other two nail-bone units and the controls. Conclusions: These results question the safety of immediate full weight bearing following surgery when treating the reverse oblique unstable fractures with DePuy intramedullary nails. A period of partial weight bearing following fixation of reverse oblique fractures would be wise when using DePuy nails.

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“…1-3 A betegekkel a részleges terhelést, te hermentesítést hagyományos módon egy mérleg segítségével próbálják megtanítani, de ez az esetek túlnyomó részében nem elég haté-kony. [4][5][6][7] A technika fejlődésével számos, a talp alatt elhelyezett érzékelőkkel ellátott rendszer született a probléma megoldására, azonban ezek sem tudták meghozni az igazi áttörést. 8,9 A Metalelektro Méréstechnika Kft.…”

Section: Bevezetésunclassified

Application of a vibrating device for the prevention of flexion contracture after total knee arthroplasty

Manó

Pálinkás

Szabó

et al. 2014

Eur J Orthop Surg Traumatol

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Absztrakt 2012-ben indult az a három részből álló klinikai vizsgálatsorozat, amely során a DE OEC Ortopédiai Klinika, a Kenézy Gyula Kórház és Rendelőintézet Rehabilitációs Osztálya és a DE OEC Orvosi Rehabilitáció és Fizikális Medicina Tanszéke tesztelte a Metalelektro Méréstechnika Kft. által kifejlesztett Angel Heel nevezetű rendszert. A hangvisszajelzésen alapuló, az alsóvégtag részleges tehermentesítésének kontrollálását és betanítását szolgáló rendszer tesztjei 150, főleg térd-és csípőízületi total endoprosthesis (TEP) műtéten átesett résztvevő bevonásával, egy év alatt zajlottak le. Az összesített eredmények azt mutatták, hogy a rendszer hangvisszajelzésének alkalmazásával az előre meghatározott maximális terhelést a betegek mintegy 54%-kal kisebb arányban lépik túl, valamint a túlterhelés mértéke is jelentősen, 27%-kal csökkent a hangjelzés alkalmazása nélküli esethez képest. A klinikai vizsgálatok egyértelműen bizonyították az Angel Heel rendszer hatékonyságát, hiszen lényegesen lecsökkenti a rehabilitáció során a káros követ-kezményekkel járó alsóvégtag-túlterhelések arányát és mértékét is. Kulcsszavak: alsóvégtag részleges tehermentesítése, Angel Heel, klinikai vizsgálat, hangvisszajelzés Angel Heel system: a new device for training and controlling partial lower limb weight bearing AbstractIn 2012 a three-round clinical trial started to test a new system developed by Metalelektro Méréstechnika Ltd. called Angel Heel by three different medical institutes. The tests of the system that was developed for controlling and training partial weight bearing based on acoustic feedback were performed with 150 people (in most cases after a hip or knee Total EndoProsthesis [TEP] surgery) in one year. The summarized results showed that the rate of patients' lower limb overload decreased by 54% when the acoustic feedback of the system was activated. Also, the absolute amount of the overload was signifi cantly decreased (by 27%) related to the case when the acoustic feedback was deactivated. The clinical trial clearly proved the effi ciency of the Angel Heel system because it significantly decreased the amount and the rate of the injurious lower limb overloads during the rehabilitation.

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How Accurate Is Partial Weightbearing?

Cited by 70 publications

References 12 publications

Are current methods of partial weight-bearing instruction accurately translating to crutch-assisted gait?

Are current methods of partial weight-bearing instruction accurately translating to crutch-assisted gait?

Three different interlocking intramedullary nails for unstable reverse oblique inter-trochanteric fractures: a bio-mechanical comparative study

Application of a vibrating device for the prevention of flexion contracture after total knee arthroplasty

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