Biofeedback in Partial Weight Bearing: Validity of 3 Different Devices.
J Orthop Sports Phys Ther. 2016 Oct 12;:1-30
Authors: van Lieshout R, Stukstette MJ, de Bie RA, Vanwanseele B, Pisters MF
Study Design Controlled laboratory study to assess criterion-related validity, with a cross-sectional within-subject design. Background Patients with orthopaedic conditions have difficulties complying with partial weight-bearing instructions. Technological advances have resulted in biofeedback devices that offer real-time feedback. However, the accuracy of these devices is mostly unknown. Inaccurate feedback can result in incorrect lower-limb loading and may lead to delayed healing. Objectives To investigate validity of peak force measurements obtained using 3 different biofeedback devices under varying levels of partial weight-bearing categories. Methods Validity of 3 biofeedback devices (OpenGo Science, SmartStep, and SensiStep) was assessed. Healthy participants were instructed to walk at a self-selected speed with crutches under 3 different weight-bearing conditions, categorized as a percentage range of body weight: 1% to 20%, greater than 20% to 50%, and greater than 50% to 75%. Peak force data from the biofeedback devices were compared with the peak vertical ground reaction force measured with a force plate. Criterion validity was estimated using simple and regression-based Bland-Altman 95% limits of agreement and weighted kappas. Results Fifty-five healthy adults (58% male) participated. Agreement with the gold standard was substantial for SmartStep, moderate for OpenGo Science, and slight for SensiStep (weighted κ = 0.76, 0.58, and 0.19, respectively). For the 1% to 20% and greater than 20% to 50% weight-bearing categories, both the OpenGo Science and SmartStep have an acceptable limits of agreement. For the weight-bearing category greater than 50% to 75%, none of the devices had acceptable agreement. Conclusion OpenGo Science and SmartStep provided valid feedback in the lower weight-bearing categories, and SensiStep showed poor validity of feedback in all weight-bearing categories. J Orthop Sports Phys Ther, Epub 12 Oct 2016. doi:10.2519/jospt.2016.6625.
PMID: 27733088 [PubMed - as supplied by publisher]
Comparison of Muscle Activation Levels Between Healthy Individuals and Persons Who Have Undergone Anterior Cruciate Ligament Reconstruction During Different Phases of Weight-Bearing Exercises.
J Orthop Sports Phys Ther. 2016 Oct 12;:1-29
Authors: Harput G, Howard JS, Mattacola C
Study Design Cross-sectional, controlled laboratory study. Background Quantification of muscular activation during different phases of functional activities is important to understand activation deficits in individuals who have undergone anterior cruciate ligament reconstruction (ACLR). Objectives To compare activation levels of vastus medialis (VM), medial hamstrings (MH) and gluteus medius (GMed) muscles during the different phases of weight bearing tasks between individuals who had undergone ACLR and healthy controls. Methods Surface electromyography was used to measure the activation levels of VM, MH and GMed muscles in 16 participants who had undergone ACLR (average time since surgery: 4 yrs) and 15 healthy participants during the reach and return phases of the star excursion balance test (SEBT) and the ascending and descending phases of a step down task (SDT). Repeated measures ANOVAs were performed to determine whether muscle activation levels differed between groups during different phases of the tasks. Results There were significant group by phase interactions for the GMed during both SEBT and the SDT. GMed activation was lower for the ACLR group during the return phase of the posteromedial direction of the SEBT compared to the control group (P = .03). During the SDT, GMed activation was higher for the ACLR group during the ascending phase than descending phase (P<.001), while the control group showed no difference between phases (P = .707). Conclusion Individuals who have undergone ACLR have similar VM and MH activation compared to healthy individuals during different phases of the SDT and SEBT. However, phase differences for GMed activity and decreased GMed activity relative to healthy individuals were observed among ACLR participants. J Orthop Sports Phys Ther, Epub 12 Oct 2016. doi:10.2519/jospt.2016.5896.
PMID: 27733087 [PubMed - as supplied by publisher]