Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Development of a Feedback Training Protocol and Clinical Force Measuring Walker for Older Patients with Restricted Upper Extremity Weight Bearing

Version 1 : Received: 15 October 2021 / Approved: 18 October 2021 / Online: 18 October 2021 (10:43:01 CEST)

How to cite: LaPier, A. Development of a Feedback Training Protocol and Clinical Force Measuring Walker for Older Patients with Restricted Upper Extremity Weight Bearing. Preprints 2021, 2021100238 (doi: 10.20944/preprints202110.0238.v1). LaPier, A. Development of a Feedback Training Protocol and Clinical Force Measuring Walker for Older Patients with Restricted Upper Extremity Weight Bearing. Preprints 2021, 2021100238 (doi: 10.20944/preprints202110.0238.v1).

Abstract

Patients recovering from bone disruption due to trauma or surgery need to limit movement to minimize shear force, thereby protecting callus formation and osteogenesis. Patients often use their arms to assist with functional activities, but pushing is frequently limited to <10 lb (4.5 kg). With only verbal instructions, patients’ ability to accurately limit weight-bearing (WB) force is poor. A therapeutic intervention to improve patient adherence with upper extremity (UE) WB guidelines during functional mobility using an instrumented walker could be beneficial. Therefore, the purpose of this article is to describe a feedback training protocol to improve the ability to modulate weight-bearing force in older adults and then provide an overview of the efficacy of this protocol and subsequent development of a Clinical Force Measuring Walker. An instrumented walker was used to measure UE WB during functional mobility in older healthy subjects (n = 30) before, during, and after (immediately and 2 hours) a visual and auditory concurrent feedback training session. During feedback training, force was significantly reduced with all 3 sessions as compared to baseline. When using the front wheeled walker, UE WB force during the second and third feedback training trials went down compared to the first trial. During the third feedback training trial, force was greater than the two previous trials while transferring sit-to-stand and stand-to-sit. After completion of practice with feedback, UE WB force was significantly reduced and remained so 2 hours later. These findings suggest that feedback training is effective for helping patients to modulate UE WB. Use of an instrumented walker and feedback training would be beneficial in clinical practice, especially with older patients. A more intensive feedback training with additional trials and or simultaneous visual and auditory cues during whole-practice may be needed to get UE WB below a 10 lb threshold.

Keywords

Median sternotomy; Ossification; Cardiac surgery; Rehabilitation; Functional mobility; Bone fracture; Assistive device; Feedback training; Sternal precautions; Instrumented walker

Subject

ENGINEERING, Biomedical & Chemical Engineering

Comments (0)

We encourage comments and feedback from a broad range of readers. See criteria for comments and our diversity statement.

Leave a public comment
Send a private comment to the author(s)
Views 0
Downloads 0
Comments 0
Metrics 0


×
Alerts
Notify me about updates to this article or when a peer-reviewed version is published.
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here.