scholarly journals Development of a Wearable Live-feedback System to Support Partial Weight-bearing While Recovering From Lower Extremity Injuries

2016 ◽  
Vol 147 ◽  
pp. 157-162 ◽  
Author(s):  
A. Tkachenko Bril ◽  
V. David ◽  
M. Scherer ◽  
H. Jagos ◽  
P. Kafka ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Weight Bearing ◽  
Feedback System ◽  
Partial Weight Bearing ◽  
Lower Extremity Injuries ◽  
Extremity Injuries ◽  
Partial Weight

scholarly journals Progress on Clinical Trials and Product Development of a Simple, Inexpensive Feedback Device for Patients Requiring Partial Weight Bearing

2008 ◽  
Vol 2 (2) ◽  
Author(s):  
Daniel Walczyk ◽  
Nathaniel Ordway ◽  
Kenneth Mann ◽  
William Ziomek
Keyword(s):  
Clinical Trials ◽  
Weight Bearing ◽  
Standard Of Care ◽  
Verbal Instruction ◽  
Partial Weight Bearing ◽  
Load Range ◽  
Lower Extremity Injuries ◽  
Scale Method ◽  
Extremity Injuries ◽  
Partial Weight

A weight bearing indicator (WBI) has been developed and is undergoing clinical trials and commercialization. The most recent version of the device includes load range indication ability. The WBI is installed in a patient’s medical appliance (e.g. cam walker boot, surgical shoe) and allows patients recovering from lower extremity injuries to self monitor their rehabilitation. It is a simple and inexpensive mechanical device that utilizes the reversible buckling phenomena of a snap dome to provide a tactile ‘click’ and an audible ‘snap’ when a specified ground load on the bottom of a patient’s foot, which has been prescribed by an orthopedist or podiatrist as the partial weight bearing (PWB) upper limit, has been met or exceeded. A clinical study involving 20 subjects showed that PWB compliance improved when comparing the WBI device to standard of care approaches such as verbal instruction and the weight scale method. Specifically, PWB compliance improved from 58% and 45% body weight (BW) for verbal instruction and weight scale method, respectively, to 33% BW for the WBI device. In addition, PWB compliance using the WBI device was not dependent on subject weight like the standard of care approaches. Sometimes patients are instructed not only to avoid exceeding an upper load limit, but also to maintain their limb load above a lower limit as well. A newer version of the WBI has been developed that provides two distinct clicks to a patient corresponding to an upper and lower load limits.

An Inexpensive Weight Bearing Indicator With Load Range Capability for Rehabilitation of Patients With Lower Extremity Injuries

2009 ◽  
Vol 3 (3) ◽  
Author(s):  
Daniel F. Walczyk ◽  
William T. Ziomek
Keyword(s):  
Lower Extremity ◽  
Mechanical Behavior ◽  
Weight Bearing ◽  
Load Range ◽  
Buckling Loads ◽  
Lower Extremity Injuries ◽  
Buckling Behavior ◽  
Lower Load ◽  
Extremity Injuries ◽  
Partial Weight

This paper investigates the mechanical behavior and design of a patent pending device called a load range weight bearing indicator (LWBI), which provides upper and lower range indication to patients with lower extremity injuries as part of a partial weight bearing rehabilitation. The LWBI consists of two opposing stacks (a.k.a. double stack) of snap domes—bistable mechanical elements that snap through only when a threshold weight is applied—sandwiched between a load transfer plate and base plate. The mechanical behavior of a LWBI has been characterized by testing single and double stacks of snap domes in a rigid aluminum fixture using a universal testing machine. Single stacks of two to eight snap domes each exhibited very predictable and repeatable buckling behavior (i.e., stack buckling load is simply the sum of individual snap dome buckling loads) when deflected at speeds typical for patients walking with a regular gait. The double stack configuration only works when supporting legs of the opposing snap dome stacks are offset by half the angle between adjacent legs. The lower load stack buckles first, while the higher load stack buckles at its threshold load because of the very low force required to keep the lower load stack collapsed. While the presence of a spacer has little effect on the double stack buckling behavior under controlled rate deflection in a precision test fixture, it was required for proper functioning of a LWBI prototype probably because of looser dimensional tolerances. The type of substrate that snap dome stacks are in contact with has little effect on the buckling loads as long as the material is not too soft. Finally, the speed of deflection within the expected range of ambulating patients has an insignificant effect on the LWBI’s buckling behavior. A LWBI prototype was designed based on the observed characteristics of the snap dome double stack with a spacer plate between the upper and lower load stacks. The prototype was installed in a recess in the insole of a biomechanical shoe beneath the patient’s heel. The shoe with LWBI was tested by various subjects pushing on a force plate and the upper and lower buckling loads were clearly indicated to the subject by audible and tactile click and measured as ground reaction force versus time. Future work will focus on further testing of the device and refinement of the design for various medical appliances.

scholarly journals ORTHOPEDIC INJURIES IN ADOLESCENT GYMNASTS: A SYSTEMATIC REVIEW

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0011
Author(s):  
Katie Kim ◽  
Michael Saper
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Weight Bearing ◽  
The Body ◽  
Adolescent And Young Adult ◽  
Body Region ◽  
Lower Extremity Injuries ◽  
Common Location ◽  
Orthopedic Injuries ◽  
Extremity Injuries

Background: Gymnastics exposes the body to many different types of stressors ranging from repetitive motion, high impact loading, extreme weight bearing, and hyperextension. These stressors predispose the spine and upper and lower extremities to injury. In fact, among female sports, gymnastics has the highest rate of injury each year. Purpose: The purpose of this study was to systematically review the literature on location and types of orthopedic injuries in adolescent (≤20 years) gymnasts. Methods: The Pubmed, Medline, EMBASE, EBSCO (CINAHL) and Web of Science databases were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify all studies reporting orthopedic injuries in adolescent and young adult gymnasts. All aspects of injuries were extracted and analyzed including location, type and rates of orthopedic injuries. Results: Screening yielded 22 eligible studies with a total of 427,225 patients. Twenty of 22 studies reported upper extremity injuries of which four specifically focused on wrist injuries. Eight studies reported lower extremity injuries. Nine studies reported back/spinal injuries. Seven studies investigated each body location of injury; one study reported the upper extremity as the most common location for injury and six studies reported the lower extremity as the most common location for injury. Of those seven studies, five (23%) reported sprains and strains as the most common injury. One study reported fractures as the most common injury. Conclusion: There is considerable variation in reported injury location. Some studies focused specifically on the spine/back or wrist. The type of gymnastics each patient participated in was also different, contributing to which area of the body was more heavily stressed, or lacking. Current literature lacks data to fully provide evidence regarding which body region is more frequently injured and the type of injury sustained.

Haptic Biofeedback for Improving Compliance With Lower-Extremity Partial Weight Bearing

Orthopedics ◽  
2014 ◽  
Vol 37 (11) ◽  
pp. e993-e998 ◽  
Author(s):  
Michael C. Fu ◽  
Levi DeLuke ◽  
Rafael A. Buerba ◽  
Richard E. Fan ◽  
Ying (Jean) Zheng ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Weight Bearing ◽  
Partial Weight Bearing ◽  
Partial Weight

Partial weight bearing after surgery for fractures of the lower extremity – is it achievable?

2006 ◽  
Vol 23 (1) ◽  
pp. 99-105 ◽  
Author(s):  
Attila Vasarhelyi ◽  
Tobias Baumert ◽  
Christoph Fritsch ◽  
Werner Hopfenmüller ◽  
Georg Gradl ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Weight Bearing ◽  
Partial Weight Bearing ◽  
Partial Weight

scholarly journals Analysis of partial weight bearing after surgical treatment in patients with injuries of the lower extremity

2020 ◽  
Author(s):  
Alexander Maximilian Eickhoff ◽  
Raffael Cintean ◽  
Carina Fiedler ◽  
Florian Gebhard ◽  
Konrad Schütze ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lower Extremity ◽  
Weight Bearing ◽  
Partial Weight Bearing ◽  
Partial Weight

An Inexpensive Weight Bearing Indicator Used for Rehabilitation of Patients With Lower Extremity Injuries

2006 ◽  
Vol 1 (1) ◽  
pp. 38-46 ◽  
Author(s):  
Daniel F. Walczyk ◽  
John P. Bartlet
Keyword(s):  
Lower Extremity ◽  
Medical Device ◽  
Weight Bearing ◽  
Performance Testing ◽  
Buckling Load ◽  
Manufacturing Cost ◽  
Lower Extremity Injuries ◽  
New Device ◽  
Load Monitoring ◽  
Extremity Injuries

Background. Partial or nonweight bearing is a useful treatment prescribed by medical professionals (e.g., orthopedists, podiatrists) for patients rehabilitating from lower extremity injuries However, there is significant variability in patient conformance with the commonly used, but very imprecise “weight scale method.” Furthermore, the few commercially available load monitoring devices are rarely used because of their high cost. Method of Approach. As a simple and inexpensive alternative to current load monitoring methods and commercial products, a new medical device called a snap dome weight bearing indicator (WBI) has been developed to gently warn a patient when they have exceeded a limited percentage of their body weight on the recovering leg or foot. When installed in a patient’s shoe or medical appliance, the device does so by utilizing the reversible buckling phenomena of a snap dome to provide a tactile and audible feedback when the prescribed weight has been exceeded. To demonstrate the feasibility of this new device, the performance of (1) the snap dome by itself and (2) several WBI designs developed were tested. The most useful of the new designs include one incorporating a heel cup for loose fitting medical appliances and a podiatric off-loading indicator (POLI). In addition, a pilot study and manufacturing cost analysis of the POLI device were performed to investigate patient usability and affordability issues. Results. The particular four-leg snap domes used in device prototypes performed quite well with regards to buckling load consistency between domes, the linearity of buckling load by stacking domes in a parallel arrangement, and buckling load repeatability of a single dome. The performance of each WBI prototype was tested with regards to load transfer, tactile, and audible feedback to the patient, patient comfort, and ease of installation. Prototype performance was generally very good or excellent except for the POLI device, which does not provide sufficient tactile or audible feedback for many patients. A costing analysis of the POLI device suggests that it can be manufactured in the U.S. for around one dollar. Conclusions. The generally positive results from performance testing of commercially available snap domes and WBI prototypes suggest that this new medical device will indeed be an inexpensive, yet effective conformance tool for orthopedists and podiatrists to use in prescribing partial or no weight bearing for a patient.

scholarly journals Orthopedic Surgeons and Physical Therapists Differ in Assessment of Need for Physical Therapy After Traumatic Lower-Extremity Injury

2009 ◽  
Vol 89 (12) ◽  
pp. 1337-1349 ◽  
Author(s):  
Kristin R. Archer ◽  
Ellen J. MacKenzie ◽  
Renan C. Castillo ◽  
Michael J. Bosse ◽  
Keyword(s):  
Physical Therapy ◽  
Lower Extremity ◽  
Self Efficacy ◽  
Knee Flexion ◽  
Physical Therapist ◽  
Weight Bearing ◽  
Lower Extremity Injury ◽  
Trauma Centers ◽  
Lower Extremity Injuries ◽  
Extremity Injuries

Background Lower-extremity injuries constitute the leading cause of trauma hospitalizations among people under the age of 65 years. Rehabilitation has the potential to favorably influence the outcomes associated with traumatic lower-extremity injuries. Objectives The objectives of this study were to explore variability in surgeon and physical therapist assessments of the need for physical therapy in patients with traumatic lower-extremity injuries and to determine the factors associated with assessments of need. Design This study was a retrospective cohort investigation. Methods Participants were 395 patients treated by reconstruction in the Lower-Extremity Assessment Project. They were evaluated at 8 level I trauma centers at 3, 6, and 12 months after hospitalization by an orthopedic surgeon and a physical therapist to determine the need for physical therapy. Analyses included multilevel logistic regression. Results Chi-square analyses showed that surgeon and therapist assessments of need differed statistically across trauma centers. Surgeons were more likely to assess a need for therapy at 3 months when participants had low work self-efficacy, impaired knee flexion range of motion (ROM), and weight-bearing limitations and at 6 and 12 months when participants had impaired knee flexion ROM and weight-bearing and balance limitations. Therapists were more likely to assess a need for therapy at 3 months when participants had moderate to severe pain and at 6 and 12 months when participants had low work self-efficacy, pain, impaired knee flexion ROM, and balance limitations. Conclusions The results revealed variability in assessments of the need for physical therapy at the provider and trauma center levels. Differences in provider assessments highlight the need for communication and further investigation into the outcomes and timing of physical therapy for the treatment of traumatic lower-extremity injuries.

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