The Impact of Real-Time Biofeedback on Partial Weightbearing Training: A Comparative Study.

Introduction: Partial Weight Bearing (PWB) is integral to rehabilitation protocols following orthopedic and trauma surgeries. Standard of Care (SOC) for PWB training often involves using a bathroom scale, a method criticized for its inaccuracy. This study aimed to compare SOC training in PWB with a biofeedback device (insole).

Methods: Sixty healthy participants were randomized into SOC or Biofeedback (BF) training groups, practicing 20 kg PWB using a standardized protocol. Gait data, including compliance with weightbearing restrictions (not exceeding 150% of the set weightbearing limit), was monitored using Loadsol® insole force sensors. Participant satisfaction and usability were assessed through questionnaires. Training duration and walking speed were also measured.

Results: The BF group's peak force averaged 330 Newtons, significantly lower than the SOC group's 600 Newtons, which exceeded the prescribed limit by over three times (p ≤ 0.001). Compliance with weightbearing restrictions was substantially higher in the BF group (88% or 29/33 participants) compared to the SOC group (19% or 5/27 participants) (p ≤ 0.001). The BF group also required less training time to learn PWB, averaging 9:00 ± 3:06 minutes, versus 12:49 ± 3:01 minutes in the SOC group (p ≤ 0.001). Questionnaire responses showed no significant differences between groups.

Conclusion: Real-time audio-visual Biofeedback significantly enhances compliance with weightbearing restrictions in PWB training while reducing the training duration. Based on these findings, the implementation of biofeedback devices in PWB training is recommended.

Level of evidence: 3.