Effectiveness of Audio Feedback for Partial Weight-Bearing in and Outside the Hospital: A Randomized Controlled Trial

` Hurkmans HL, Bussmann JB, Benda E, Verhaar JA, Stam HJ. Effectiveness of audio feedback for partial weight-bearing in and outside the hospital: a randomized controlled trial. Arch Phys Med Rehabil 2012;93:565-70. Objective: To determine the effectiveness of partial weight-bearing (PWB) training with audio feedback in patients after total hip arthroplasty (THA). Design: Randomized controlled trial. Setting: Orthopedic clinic and patients' homes. Participants: Patients (N=38) after THA with trochanteric osteotomy. Intervention: Patients were trained with (n=18) or without (n=20) audio feedback to perform PWB at a 10% body weight (BW) target load. PWB training started on day 2 or 3 postoperatively and was given once per day during the entire hospital stay. Main Outcome Measures: Mean peak load (%BW), and the percentage of steps below, equal to, and above the target load. Weight-bearing was measured using an insole pressure system on postoperative day 7 in the hospital during PWB training (condition 1 [C1]) and when patients walked unsupervised (condition 2 [C2]), and on postoperative clay 21 at home (condition 3 [C3]). Results: PWB training with audio feedback resulted in better PWB (11.1% BW vs control, 21.9% BW; P=.006) at C1. The audio feedback group had more steps below the target load (21.4% vs control, 7.8%; P=.020) and fewer steps above the target load (15.6% vs control, 45.0%; P=.015). For C2 and C3, no significant differences were found between the patients receiving PWB training with and without audio feedback, for all outcome measures. Conclusions: Patients with THA who received audio feedback were able to accurately perform PWB at the prescribed target load during PWB training, but were unable to replicate the prescribed target load when they walked unsupervised in the hospital or at home.