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CLINICAL USE OF SMARTSTEP IN WEIGHT BEARING CONTROL



Abstract

Introduction: Each year millions of people are treated for hip, knee or foot surgery which require rehabilitation programs that typically involve limited or controlled weight bearing on an affected limb. Weight bearing reduces edema & facilitate rapid rehabilitation.

Current weight-bearing instruction protocols involve non-quantitative guidelines, based on the patient’s amount of discomfort while walking or subjective perception. However, the interpretation of these instructions is inaccurate and subjective, and varies among clinicians and patients.

New biofeedback technology concepts are beginning to be implemented in the rehabilitation process. The Smart-Step system is a new weight bearing monitoring system that assists clinicians and physical therapists to accurately assess, train and monitor patients’ weight bearing capabilities.

Purpose: To assess the effectiveness of the SmartStep system in guiding weight bearing restrictions, and to assess the effectiveness of the SmartStep system as a tool to reeducate full weight bearing.

Material and Methods: 8 Patients in the Orthopedic rehabilitation department & 5 patients in the orthopedic physiotherapy out-patient clinic, post orthopedic surgery with FWB instructions were randomly divided into Study & Control groups.

During treatment, the patients were trained by the PT in FWB according to the instruction of the surgeon. Data of age and body weight was collected from all patients. Patients in both study groups used the SmartStep System. This system consists of an in-shoe inflatable insole, pressure sensors and a control unit for data storage. The control unit provides also an audio signal whenever the patient was bearing body weight at a recommended and pre-calibrated level.

Results: The mean age and body weight were 62±12 years and 76±15 kg in the study group and 65±15 years and 70±13 kg in the control group.

Data obtained in both groups (in kg) during the pre-test and during the gait tests was converted into percentage of the patients BW. The means of the differences between the pre-test results and the gait test results in both groups were 9 + 6.7% and 1.5 + 6% in the study and control group, respectably (p=0.0002).

Conclusions: The new Smartstep system was proved to be a useful tool in assisting gait rehabilitation since its biofeedback system enhances and improves weight bearing over the affected limb in cases where FWB is recommended.

The abstracts were prepared by Ms Orah Naor. Correspondence should be addressed to Israel Orthopaedic Association at PO Box 7845, Haifa 31074, Israel.