Comparison of Feedback Approaches to Improve Training in Partial Weight-Bearing.

Assistive devices, including canes or crutches, are used in partial weight-bearing (PWB) to offload weight from limbs weakened by disease or injury, promote recovery, and prevent reinjury. While weight must be offloaded accurately to target loads prescribed by healthcare providers for maximum benefit, current training methods result in poor adherence. It is, however, currently unknown how best to provide feedback during training so that users can build an accurate internal model for PWB. In this work, we investigate seven feedback schemes using an instrumented cane, which vary the modality, timing, and the level of detail provided. We find that auditory schemes and a retrospective visual scheme outperform current clinical practices for PWB training. These findings provide results that can be applied directly to improve current clinical practices and provide valuable new insight into the design of feedback for training internal models in force-based motor control tasks. Clinically, this work presents a simple modification to clinical PWB training practices that can improve compliance by up to 75%, positively influencing rehabilitation outcomes and reducing the risk of complications.