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 A newer version of the WBI has been developed that provides two distinct clicks to a patient corresponding to an upper and lower load limits.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 Differences in femoral component subsidence rate after THA using an uncemented collarless femoral stem: full weight-bearing with an enhanced recovery rehabilitation versus partial weight-bearing

2021 ◽  
Author(s):  
Franziska Leiss ◽  
Julia Sabrina Götz ◽  
Matthias Meyer ◽  
Günther Maderbacher ◽  
Jan Reinhard ◽  
...  
Keyword(s):  
Risk Factors ◽  
Enhanced Recovery ◽  
Weight Bearing ◽  
Femoral Stem ◽  
Full Weight Bearing ◽  
Partial Weight Bearing ◽  
Fill Ratio ◽  
Stem Subsidence ◽  
Partial Weight

Abstract Background Femoral component subsidence is a known risk factor for early failure of total hip arthroplasty (THA) using cementless stems. The aim of the study was to compare an enhanced recovery concept with early full weight-bearing rehabilitation and partial weight-bearing on stem subsidence. In addition, the influence of patient-related and anatomical risk factors on subsidence shall be assessed. Methods One hundred and fourteen patients underwent primary cementless THA and were retrospectively analyzed. Sixty-three patients had an enhanced recovery rehabilitation with early full weight-bearing and 51 patients had rehabilitation with partial weight-bearing (20 kg) for 6 weeks. Postoperative subsidence was analyzed on standing pelvic anterior–posterior radiographs after 4 weeks and 1 year. Subsidence was measured in mm. Anatomical and prosthetic risk factors (stem size, canal flare index, canal fill ratio as well as BMI and demographic data) were correlated. Results Femoral stem subsidence rate was significantly higher for the group with an enhanced recovery concept compared to the group with partial weight-bearing at the first radiological follow up after 4 weeks [2.54 mm (SD ± 1.86) vs. 1.55 mm (SD ± 1.80)] and the second radiological follow up after 1 year [3.43 mm (SD ± 2.24) vs. 1.94 (SD ± 2.16)] (p < 0.001, respectively). Stem angulation > 3° had a significant influence on subsidence. Canal flare index and canal fill ratio showed no significant correlation with subsidence as well as BMI and age. Conclusion In the present study, cementless stem subsidence was significantly higher in the group with enhanced recovery rehabilitation compared to partial weight-bearing. Small absolute values and differences were demonstrated and therefore possibly below clinical relevance. Anatomical radiological parameters and anthropometric data did not appear to be risk factors for stem subsidence.

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.

scholarly journals How do orthopaedic surgeons and rehabilitation professionals interpret and assess ‘toe touch’ weight bearing and ‘partial’ weight bearing status in the rehabilitation setting?

2018 ◽  
Vol 4 (1) ◽  
pp. e000326 ◽  
Author(s):  
Stephen G Thompson ◽  
Rhodri D Phillip ◽  
Andrew Roberts
Keyword(s):  
Weight Bearing ◽  
Total Body Weight ◽  
Medical Rehabilitation ◽  
Partial Weight Bearing ◽  
Rehabilitation Centre ◽  
Orthopaedic Surgeons ◽  
Rehabilitation Professionals ◽  
Wide Range ◽  
Significant Difference ◽  
Partial Weight

AimTo compare the interpretation of toe touch weight bearing (TTWB) and partial weight bearing (PWB) among orthopaedic surgeons, rehabilitation professionals and patients.Methodology78 consultant and middle-grade orthopaedic surgeons in the UK completed a questionnaire. 64 rehabilitation professionals (including physiotherapists) at Defence Medical Rehabilitation Centre Headley Court were also recruited. Both groups provided their interpretation of TTWB and PWB as a percentage of total body weight (%TBW). Each rehabilitation professional, then applied what they interpreted to be TTWB and PWB using a Lasar Posture weighing device. The predicted values were compared with the actual values demonstrated.ResultsThere was no significant difference between orthopaedic surgeons and rehabilitation professionals in their interpretation of TTWB and PWB, however there was a wide range of responses. There was a significant difference between the predicted %TBW and the actual values demonstrated by the ‘educated patient’ (mean difference 4.8 (TTWB) and 22.9 (PWB)).ConclusionHealthcare professionals vary greatly in their interpretation of the terms TTWB and PWB. Therefore, for a consistency in rehabilitation delivery the terms should not be used in isolation without a further descriptor. Static measures of weight application are lower than people think they are applying. We encourage the use of loading practice with a scale to reassure and educate patients.

scholarly journals Femoral neck stress fracture in a young female recruit: case report

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 16 ◽  
Author(s):  
Hélder Fonte ◽  
Ricardo Rodrigues-Pinto
Keyword(s):  
Femoral Neck ◽  
Stress Fracture ◽  
Early Recognition ◽  
Weight Bearing ◽  
Full Weight Bearing ◽  
Imaging Studies ◽  
Partial Weight Bearing ◽  
Military Recruit ◽  
Femoral Neck Stress Fracture ◽  
Partial Weight

Introduction: Femoral neck stress fractures are uncommon and depending on their location, can be at high risk for non-union and significant morbidity.  Their prevalence is higher among runners and military recruits, and women seem to be at higher risk. Methods: A 27-year-old female, who was enrolled in military recruit, reported left side groin pain after a strenuous running exercise. Due to persistent pain an X-Ray was ordered, which revealed no signs of acute lesions. Further imaging studies with CT scan and MRI identified a compression-type femoral neck stress fracture. Results: The patient was submitted to conservative treatment consisting of restricting from full weight-bearing. Six weeks after she initiated partial weight-bearing, becoming asymptomatic at seven months. Follow-up imaging studies revealed union of the fracture. Discussion: This diagnosis should be considered when evaluating military and athlete populations. Early recognition of these injuries is crucial because complication and morbidity rates are high.

scholarly journals Surgical Repair of Open Achilles Tendon Injuries Using No.1 Prolene to Pull Down the Proximal Tendon: A Safe Technique

1970 ◽  
Vol 21 (2) ◽  
pp. 132-134
Author(s):  
Sayed Ahmed ◽  
Debashis Roy ◽  
S Uddin Ahmed ◽  
M Enamul Haque ◽  
Moshidur Rahman
Keyword(s):  
Suture Material ◽  
Weight Bearing ◽  
Full Range ◽  
Neutral Position ◽  
Partial Weight Bearing ◽  
Active Flexion ◽  
Safe Technique ◽  
Partial Weight ◽  
Distal Tendon

From July 1998 to October 2004 forty-seven patients with open tendo-Achilles injuries were treated pull down the proximal tendon with no.1 prolene. In this surgical method no.1 prolene was threaded through the proximal tendon and the same suture material passed through the distal tendon and its bilateral ends were tightened over the rubber button either under the heel or by the sides of the heel. Box sutures apposed cut ends of the tendon. The ankle was placed in the cast in near neutral position. At six weeks the cast was removed and active flexion program was started. Partial weight bearing was allowed at seven weeks and full bearing was allowed at ten weeks after surgery. The average follow up period is 1.8 years. All the patients exhibited full range of motion at the final follow-up. doi: 10.3329/taj.v21i2.3792 TAJ 2008; 21(2): 132-134

scholarly journals Comparison of 8-year knee osteoarthritis progression in 2 siblings: a case-based review

2020 ◽  
Author(s):  
Margaret L. Gourlay ◽  
Linda L. Gourlay
Keyword(s):  
Knee Osteoarthritis ◽  
Fluid Model ◽  
Weight Bearing ◽  
Knee Injuries ◽  
Original Research ◽  
Partial Weight Bearing ◽  
Clinical Model ◽  
Pubmed Database ◽  
The Right ◽  
Partial Weight

Abstract Because the pathophysiology of knee osteoarthritis is poorly understood, optimal evidence-based clinical management is uncertain. Sibling comparison studies can help inform a clinical model to guide preventive care. We compared the 8-year clinical outcomes in 2 sisters with a family history of osteoarthritis, normal BMI, and absence of knee pain at baseline. Both patients had Kellgren–Lawrence grade 1 in the affected knee at the time of twisting knee injuries leading to osteoarthritis diagnoses at age 50 (patient 1) and 51 (patient 2). Patient 1 developed a chronic right knee effusion, and progressed to Kellgren–Lawrence grade 3 bilaterally by the time she had a right total knee replacement at age 58. Patient 2 had subchondral fractures of the right knee with transient effusion, which healed after 1 year of partial weight-bearing with crutches and subsequent daily use of knee sleeves. Patient 2 had Kellgren–Lawrence grade 0 bilaterally upon surveillance imaging at age 58. The terms “osteoarthritis and knee and diagnostic imaging and subchondral bone and pathophysiology” were searched in the PubMed database to identify original research articles to inform a clinical model consistent with the patients’ outcomes. A fluid model of osteoarthritis was the best explanatory model for the discordant clinical trajectories of the age-matched siblings. Patient recommendations are presented based on these findings.

Sign in / Sign up

Export Citation Format

Share Document