Publication

A new continuous gait analysis system for ankle fracture aftercare

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Background Correct aftercare following lower extremity fractures remains a controversial issue. Reliable, clinically applicable weightbearing recommendations have not yet been defined. The aim of the current study was to establish a new gait analysis insole during physical therapy aftercare of ankle fractures to test patients’ continuous, longterm compliance to partial weight-bearing restrictions and investigate whether patients can estimate theirweight-bearing compliance.
Materials and Methods The postoperative gait of 14 patients after operative treatment of Weber B-type ankle fractures was monitored continuously for six weeks (OpenGO, Moticon GmbH, Munich). All patients were instructed and trained by physical therapists on how to maintain partial weight-bearing for this time. Discontinuous (three, six and twelve weeks) clinical (patient questionnaire, visual analogue pain score [VAS]) and radiographic controls were performed.
Results Despite the set weight-bearing limits, individual ranges for overall weight-bearing (range 5–107% of the contralateral side) and patient activity (range 0–366 min/day) could be shown. A good correlation between weight-bearing and pain was seen (rs = –0.68; p = <0.0001). Patients significantly underestimated their weight-bearing time over the set limit (2.3 ± 1.4min/day vs. real: 12.6 ± 5.9min/day; p < 0.01).
Conclusions Standardized aftercare protocols and repeated training alone cannot ensure compliance to postoperative partial weightbearing. Patients unconsciously increased weight-bearing based on their pain level. This study shows that new, individual and possibly technology-assistedweight-bearing regimes are needed. The introduced measuring device is feasible to monitor and steer patientweightbearing during future studies.

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