| 2016

“Open-Go-Science” for better adaption and rehabilitation after fractures and operations of the lower extremities

Johannes Deininger

Technische Universität München Klinik und Poliklinik für Unfallchirurgie


rehabilitation, aftercare, fracture, plantar pressure measurement


The Regulation of partial weight bearing is a common and accepted treatment concept in medicine. However, there are no reliable data on the cure-optimized ground contact forces and duration of the partial load. Measuring the ground contact forces and the mobility of patients after operations with a regime of partial weight bearing represents a conceivable solution. Using this data, it should be possible to make conclusions about the optimal degree of partial load. The aim of the study was to improve the "Open-Go-Science" -insoles so that they are available for subsequent long-term measurements of operated patients. The sensor sole should be able to measure and record the ground reaction forces with sufficient validity and reliability. It should also be investigated to what extent the 20 included subjects (inclusion criteria: <40 years active in sports, no illnesses, especially not of the musculoskeletal system) can keep a regime of 150N load during a 500m long course going on crutches. The study consisted of three parts : 1. First correlation and conditioning phase 2. Passing of the course under 150N partial weight bearing and logging the ground reaction forces by the sensor sole 3. Second correlation and conditioning phase The subjects were instructed and trained in the physiological running on crutches. The sensor sole has been inserted into clinic usual VACOped boots and been started to record. While the correlation and conditioning phase target contact forces were put on a Kistler force plate from subjects with VACOped boots. This was integrated into a catwalk to ensure a floor-level transition. The aim of target contact forces were: 15 x 450N, 300N and 15 x 15 x 150N . These were collected and recorded in parallel by both the measurement base as well as from the force plate. After this, the 500m long course followed under 150N prescribed partial weight bearing, going on crutches. It included horizontal and inclined planes and climbing stairs. The ground reaction forces of each step were stored here from the insole. After the course, the correlation and conditioning phase was repeated identically. This served to verify the reliability of the insole data. To detect measurement inaccuracies of the sensor insole, every 1800 measurement points of the force plate were compared with the 1800 the measurement base collected. This data was by means of Bland - Altman plots and the methodology by Passing and Bablok were statistically analyzed. It showed that the subjects could not only not comply to the 150N part weight bearing. Moreover the reliability of the measurement electronics is shown, as precise enough for a first use in clinical trials. The absolute error of the insoles was at a target weight of 150N -9,9N. It should now be possible to collect details of postoperative partial weight bearing of patients in long term studies using this measurement technology In follow-up studies. Using this all-day data, it should be able to draw conclusions on the effectiveness of patient education, patient compliance and the limitations of part load regulation in future.

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