Department of Trauma Surgery and Orthopaedics, Klinikum Stuttgart - Katharinenhospital, Kriegsbergstraße 60, 70174, Stuttgart, Germany.
Arch Orthop Trauma Surg. 2024 Jul;144(7):3113-3119. doi: 10.1007/s00402-024-05406-2. Epub 2024 Jun 20.
This study investigates the learning efficacy for partial weight load before discharge as well as the impact of biofeedback during the learning process.
We monitored weight-bearing in 57 patients who had surgery for ankle fractures. Continuous measurements without and with biofeedback were performed in the early postoperative stage in order to, first, assess how well these patients could apply what they have learned before being discharged, and second, to examine the influence of biofeedback.
Using conventional teaching methods, only about one-third of patients (36.8% on the ground and 29.2% on the stairs) were able to maintain a satisfactory load. One-fourth of the patients did not place any weight on their leg, which was shown to be due to excessive pain at the time of the measurement (p < 0.05). A further one-fourth loaded inadequately low, while the remainder loaded excessively. Patients benefited significantly from the activation of audio-visual biofeedback in real time. As a result, loads in a target zone between 15 and 30 kg could be significantly increased (p < 0.05).
We conclude that the majority of ankle fracture patients were unable to learn partial weight bearing in the early postoperative stage using traditional techniques. Additionally, each patient's ability to carry out a given loading varied. Using an audio-visual real-time biofeedback modality led to significantly improved performance. These findings support the proposed utility of audiovisual feedback in early rehabilitation. With the use of outpatient real-time biofeedback systems, therapists will be able to respond specifically to the needs of each individual patient.
Trial registration: DRKS00031136, Registered 01.02.2023 - Retrospectively registered, https://www.drks.de/DRKS00031136.
本研究旨在探讨部分负重在出院前的学习效果，以及生物反馈在学习过程中的影响。
我们监测了 57 例踝关节骨折手术患者的负重情况。在术后早期，我们进行了无生物反馈和有生物反馈的连续测量，以便首先评估这些患者在出院前能够很好地应用所学知识的程度，其次评估生物反馈的影响。
使用传统教学方法，只有约三分之一的患者（地面上的 36.8%和楼梯上的 29.2%）能够保持满意的负荷。四分之一的患者腿部没有承重，这是由于测量时疼痛过度（p<0.05）。另有四分之一的患者承重不足，而其余的患者承重过度。患者从实时视听生物反馈的激活中显著受益。结果，目标区域（15-30kg）之间的负载可以显著增加（p<0.05）。
我们得出结论，大多数踝关节骨折患者在术后早期阶段无法使用传统技术学习部分负重。此外，每个患者的承重能力各不相同。使用视听实时生物反馈模式可显著提高性能。这些发现支持在早期康复中使用视听反馈的建议。通过使用门诊实时生物反馈系统，治疗师将能够针对每个患者的具体需求做出具体反应。
试验注册：DRKS00031136，注册日期 2023 年 2 月 1 日-回顾性注册，https://www.drks.de/DRKS00031136。
