Department of Ortopedic Surgery, Saarland University Medical Center, Homburg, Germany.
German Research Centre for Artificial Intelligence (DFKI), Saarbrücken, Germany.
JMIR Hum Factors. 2024 Aug 16;11:e51898. doi: 10.2196/51898.
Surgical procedures on the lower extremities often require weight-bearing on crutches as part of the rehabilitation process. Orthopedic elective procedures enable patients to learn the correct use of crutches in a controlled preoperative setting. Digital assistance systems can safely circumvent a shortage of skilled staff and any contact restrictions that may be necessary.
The usability of a newly developed gait training assistant (GTA) for the use of crutches will be evaluated. An intervention group trained to use crutches by the digital trainer will be compared with a control group trained to use crutches conventionally by a physiotherapist.
As part of the development and implementation of a novel GTA, 14 patients learned to walk with crutches by completing specific exercises while receiving live feedback. Their movements were detected by a depth sensor and evaluated in real time. Specific parameters (step length, synchronous movement, crutch angle, and crutch distance to the feet) were compared with a control group (n=14) trained to use crutches by physiotherapists. The intervention group was also assessed by a physiotherapist. At the end of the study, the patients completed questionnaires to evaluate the usability of the system (Brooke's System Usability Scale score) and patient satisfaction.
All patients trained by the novel GTA were able to use crutches correctly. The intervention group showed significantly better values for crutch angle (mean -6.3°, SD 3.5° vs mean -12.4°, SD 4.5°; P<.001) and crutch position (mean 3.3, SD 5.1 cm vs mean -8.5, SD 4.9 cm; P=.02). Both groups reported that they felt confident in the use of crutches, were able to follow the instructions, and enjoyed the training. Even though the majority (12/14, 86%) preferred physical therapy over a purely digital approach, most participants enjoyed using the system (13/14, 93%) and were interested in trying out other digital assistants (11/14, 79%). The usability of the GTA was rated above average by the majority (9/14, 64%) of the patients.
The newly designed GTA is a safe method of teaching the use of crutches and is statistically superior to training by a physiotherapist. Even if patients prefer interaction with a physiotherapist over a purely digital approach, digital devices provide a safe and motivating opportunity to learn the essential locomotor skills for rehabilitation.
下肢手术通常需要在康复过程中使用拐杖承重。矫形选修手术使患者能够在术前控制环境中学习正确使用拐杖。数字辅助系统可以安全地规避熟练员工短缺和任何必要的接触限制。
评估新开发的步态训练辅助器（GTA）在拐杖使用方面的可用性。将接受数字训练器培训使用拐杖的干预组与接受物理治疗师常规培训使用拐杖的对照组进行比较。
作为新型 GTA 开发和实施的一部分，14 名患者通过完成特定练习来学习使用拐杖，并同时获得实时反馈。他们的动作由深度传感器检测，并实时评估。特定参数（步长、同步运动、拐杖角度和拐杖与脚的距离）与对照组（n=14）进行比较，对照组由物理治疗师培训使用拐杖。干预组还由物理治疗师进行评估。研究结束时，患者完成了评估系统可用性的问卷（Brooke 的系统可用性量表评分）和患者满意度。
所有通过新型 GTA 训练的患者都能够正确使用拐杖。干预组的拐杖角度（平均-6.3°，SD 3.5°vs 平均-12.4°，SD 4.5°；P<.001）和拐杖位置（平均 3.3，SD 5.1 cm vs 平均-8.5，SD 4.9 cm；P=.02）的数值明显更好。两个组都报告说，他们对使用拐杖有信心，能够按照说明进行操作，并享受训练。尽管大多数患者（12/14，86%）更喜欢物理治疗而不是纯粹的数字方法，但大多数参与者喜欢使用该系统（13/14，93%），并对尝试其他数字助手感兴趣（11/14，79%）。大多数患者（9/14，64%）对 GTA 的可用性评价为高于平均水平。
新设计的 GTA 是一种教授拐杖使用的安全方法，在统计学上优于物理治疗师的培训。即使患者更喜欢与物理治疗师进行互动而不是纯粹的数字方法，数字设备也提供了一个安全且有动力的机会来学习康复所需的基本运动技能。
