Ankle Fracture Gait Training Through Musical Feedback: Case Study

Background: Trimalleolar ankle fractures often result in mobility and gait impairments. To date, there is little consensus on the rehabilitation regimen. Biofeedback is an emerging approach that improves gait in different populations; here, we utilized novel, customized musical biofeedback to retrain gait following a trimalleolar ankle fracture.   Case Presentation: A 56-year-old male sustained a right trimalleolar ankle fracture and underwent surgical fixation, followed by immobilization, progressive weight bearing, and a regular physical therapy regimen. Additional gait training sessions were provided with musical feedback from pressure-sensing insoles to provide accurate cues to encourage medialized load pressure and prevent avoidance behavior.   Outcome and Follow-Up: Mobility, functionality, stance phase, stride length, total force distribution, and plantar pressure improved after training.   Discussion: This is the first study on gait training after an ankle fracture using customized pressure-based biofeedback with music to normalize plantar pressure at the push-off phase.