Department of Trauma & Orthopaedics, St George's University Hospitals NHS Foundation Trust, London, UK.
Department of Trauma & Orthopaedics, Epsom & St Helier University Hospitals NHS Trust, London, UK.
Injury. 2022 Feb;53(2):427-433. doi: 10.1016/j.injury.2021.12.019. Epub 2021 Dec 12.
Weight-bearing (WB) status following a fracture or surgical fixation is an important determinant of the mechanical environment for healing. In order for healthcare professionals to communicate and understand the extent of bearing weight through a limb, clear terminology must be used. There is widespread variation in the usage and definitions of WB terminology in the literature and clinical practice. This study sought to define the understanding and extent of variation across the United Kingdom.
A nationwide online survey of UK-based Trauma & Orthopaedic (T&O) multidisciplinary healthcare professionals was conducted. Participants answered seven questions assessing their usage and understanding of various WB terminology.
A total of 707 responses were received: 48% by doctors, 32% by physiotherapists, 13% by occupational therapists and 7% from other healthcare professionals. In terms of understanding of WB terminology with respect to percentage body weight (BW), 89% of respondents interpret 'full WB' as 100% BW, 97% interpret 'non WB' as 0% BW, 80% interpret 'partial WB' as 50% BW, and 89% interpret 'touch/toe-touch WB' as 10% or 20% BW. There were statistically significant differences between the responses of doctors and therapists for these four terms, with doctors tending to give higher %BW values. 'Protected WB' and 'WB as tolerated' had less consensus and more variability in responses. The majority (68%) of respondents do not usually quantify terminology such as 'partial WB' with a value, and 94% agreed that standardisation of WB terminology would improve communication amongst professionals.
This study provides evidence of the substantial variation in the understanding of WB terminology amongst healthcare professionals, which likely results in ambiguous rehabilitation advice. Existing literature has shown that patients struggle to comply with terms such as 'partial weight-bearing'. We recommend consensus within the T&O multidisciplinary community to standardise and define common weight-bearing terminology.
骨折或手术后的负重（WB）状态是愈合的机械环境的重要决定因素。为了让医护人员能够通过肢体来沟通和理解负重的程度，必须使用清晰的术语。在文献和临床实践中，WB 术语的使用和定义存在广泛的差异。本研究旨在确定英国范围内的理解和差异程度。
对英国各地的创伤和骨科（T&O）多学科医疗保健专业人员进行了全国性的在线调查。参与者回答了七个问题，评估了他们对各种 WB 术语的使用和理解。
共收到 707 份回复：48%来自医生，32%来自物理治疗师，13%来自职业治疗师，7%来自其他医疗保健专业人员。就理解相对于体重百分比（BW）的 WB 术语而言，89%的受访者将“完全负重”解释为 100% BW，97%将“非负重”解释为 0% BW，80%将“部分负重”解释为 50% BW，89%将“触地/足尖触地负重”解释为 10%或 20% BW。医生和治疗师对这四个术语的回答存在统计学上的显著差异，医生倾向于给出更高的 BW%值。“保护性负重”和“耐受负重”的共识较少，反应的变化也较大。大多数（68%）受访者通常不会用数值来量化术语，如“部分负重”，并且 94%的受访者同意 WB 术语的标准化将改善专业人员之间的沟通。
本研究提供了证据，证明医疗保健专业人员对 WB 术语的理解存在很大差异，这可能导致康复建议不明确。现有文献表明，患者难以遵守“部分负重”等术语。我们建议 T&O 多学科社区内部达成共识，以标准化和定义常见的负重术语。
