2016

PLoS ONE 11 (10)

Biofeedback in Partial Weight Bearing: Usability of Two Different Devices from a Patient’s and Physical Therapist’s Perspective

Remko van Lieshout, PT, MSc, Mirelle J. Stukstette, PT, PhD, Rob A. de Bie, PT, PhD, Benedicte Vanwanseele, PhD, Martijn, F. Pfisters, PT, PhD

Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht

Keywords

Physiotherapy, Cell phones, Surgical and invasive medical procedures, Measurement equipment, Ankles, Orthopedic surgery, Patients, Hip

Abstract

Background Partial weight bearing is frequently instructed by physical therapists in patients after lower-limb trauma or surgery. The use of biofeedback devices seems promising to improve the patient’s compliance with weight-bearing instructions. SmartStep and OpenGo-Science are biofeedback devices that provide real-time feedback. For a successful implementation, usability of the devices is a critical aspect and should be tested from a user’s perspective. Aim To describe the usability from the physical therapists’ and a patients’ perspective of Smartstep and OpenGo-Science to provide feedback on partial weight bearing during supervised rehabilitation of patients after lower-limb trauma or surgery. Methods In a convergent mixed-methods design, qualitative and quantitative data were collected. Usability was subdivided into user performance, satisfaction and acceptability. Patients prescribed with partial weight bearing and their physical therapists were asked to use SmartStep and OpenGo-Science during supervised rehabilitation. Usability was qualitatively tested by a think-aloud method and a semi-structured interview and quantitatively tested by the System-Usability-Scale (SUS) and closed questions. For the qualitative data thematic content analyses were used. Results Nine pairs of physical therapists and their patients participated. The mean SUS scores for patients and physical therapists were for SmartStep 70 and 53, and for OpenGo-Science 79 and 81, respectively. Scores were interpreted with the Curved Grading Scale. The qualitative data showed that there were mixed views and perceptions from patients and physical therapists on satisfaction and acceptability. Conclusion This study gives insight in the usability of two biofeedback devices from the patient’s and physical therapist’s perspective. The overall usability from both perspectives seemed to be acceptable for OpenGo-Science. For SmartStep, overall usability seemed only acceptable from the patient’s perspective. Implication The study findings could help clinicians to decide which biofeedback device is appropriate for their given situation and provide information for future development of biofeedback devices.

Moticon's Summary

The study addresses the usability of two biofeedback devices SmartStep and Moticon’s OpenGo Science sensor insoles, used in supervised rehabilitation for patients with lower-limb trauma or surgery. Biofeedback devices offer real-time feedback to improve patient compliance with weight-bearing (WB) instructions. The mixed-methods design included both qualitative and quantitative data from patients and physical therapists (PTs) in primary, secondary, and tertiary care settings. Results indicated that patients generally found both devices acceptable, with higher satisfaction for OpenGo Science due to its comfort and ease of use. PTs preferred OpenGo Science over SmartStep, highlighting issues with SmartStep's complexity and intrusiveness. Despite some connectivity issues with OpenGo Science, PTs appreciated its simplicity and non-intrusive design. These insights can guide clinicians in selecting appropriate biofeedback tools and inform future device development for rehabilitation.

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