• Tobias Peter Merkle, Nina Hofmann, Christian Knop, and Tomás Da Silva.
• Department of Trauma Surgery and Orthopaedics, Klinikum Stuttgart - Katharinenhospital, Kriegsbergstraße 60, 70174, Stuttgart, Germany. t.merkle@klinikum-stuttgart.de.
• Arch Orthop Trauma Surg. 2024 Jul 1; 144 (7): 311331193113-3119.

PurposeThis study investigates the learning efficacy for partial weight load before discharge as well as the impact of biofeedback during the learning process.MethodsWe monitored weight-bearing in 57 patients who had surgery for ankle fractures. Continuous measurements without and with biofeedback were performed in the early postoperative stage in order to, first, assess how well these patients could apply what they have learned before being discharged, and second, to examine the influence of biofeedback.ResultsUsing conventional teaching methods, only about one-third of patients (36.8% on the ground and 29.2% on the stairs) were able to maintain a satisfactory load. One-fourth of the patients did not place any weight on their leg, which was shown to be due to excessive pain at the time of the measurement (p < 0.05). A further one-fourth loaded inadequately low, while the remainder loaded excessively. Patients benefited significantly from the activation of audio-visual biofeedback in real time. As a result, loads in a target zone between 15 and 30 kg could be significantly increased (p < 0.05).ConclusionWe conclude that the majority of ankle fracture patients were unable to learn partial weight bearing in the early postoperative stage using traditional techniques. Additionally, each patient's ability to carry out a given loading varied. Using an audio-visual real-time biofeedback modality led to significantly improved performance. These findings support the proposed utility of audiovisual feedback in early rehabilitation. With the use of outpatient real-time biofeedback systems, therapists will be able to respond specifically to the needs of each individual patient.Trial RegistrationTrial registration: DRKS00031136, Registered 01.02.2023 - Retrospectively registered, https://www.drks.de/DRKS00031136.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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