Gait Rehabilitation: a New Biofeedback Device for Monitoring and Enhancing Weight-bearing over the Affected Lower Limb

Aim: Gait rehabilitation programs often require either partial weight-bearing (PWB) or encourage full weight-bearing (FWB) on the affected limb. Until recently, there was no objective and practical way to measure correct weight-bearing during ambulation. The present study evaluates a new in-shoe device (SmartStep, Andante Medical Devices Ltd.) for measuring the amount of weight on the affected limb and for biofeedback gait training.

Methods: The first part of the study aimed to establish the validity of the SmartStep by comparing the results obtained from this device with the results obtained from a force plate. The second part aimed to evaluate the effectiveness of the SmartStep as a biofeedback method in patients who have been referred for FWB gait rehabilitation. Analysis was based on independent samples t-test and chi squared test for evaluating statistically significant differences between the 2 gait rehabilitation modes.

Results: The SmartStep could repeat the same results with 0.53 kg error of mean. Statistically significant correlation was found between results obtained from the SmartStep and from the force plate (R2=0.9067 and P=0.004). The use of the SmartStep auditory biofeedback, significantly (P=0.00031) improved patients' weight-bearing over the affected limb in the experimental group (7.9 kg +/-5.28) as compared to the control group (0.7+/-2.41 kg).

Conclusions: The SmartStep proved to be very reliable since it generated significant repeatable results which correlated significantly with those obtained from a force plate. Patients recommended for FWB gait can significantly improve body weight loading over the affected limb by the use of the SmartStep auditory biofeedback.