AO Socks for Customized Weight Bearing.
The need for evidence-based means of optimizing the walking quality of patients after surgery for fractures of the pelvis or lower limb is the primary driver behind the AO Socks for Customized Weight Bearing project, funded by the AO Strategy Fund.
Leading the two-year project is Prof Peter Brink, Chairman of Traumatology at Maastricht University Medical Center (MUMC) in the Netherlands. Brink’s project, which got underway in early 2015, has its roots in his own observations as a trauma surgeon.
“There are quite a number of soles on the market and that’s nothing new, but I want to measure more parameters than just pressure. I want to find out whether permitted weight bearing and restricted weight bearing make any difference in the quality of patients’ walking patterns after surgery for fractures of the pelvis or lower limb,” Brink explained. “In the AO books, it’s written that there should be no weight bearing for six weeks to three months, depending on the fracture type. My patients are permitted to start weight bearing as tolerated immediately after wound healing and, ultimately, I want to do the scientific research to prove that this is the right approach.”
The AO Socks for Customized Weight Bearing project is expected to result in the realization and testing of a prototype for daily life. The socks are, in the first place, envisioned as a feedback tool that could support the work of rehabilitative physicians and physical therapists. Because they would provide clinicians with empirical data about patients’ activity, the socks will serve as a means of collecting up-to-the-minute data on patients’ walking pattern.
“We know that patients do not always comply with clinicians’ instructions about weight bearing following fracture surgery,” said Brink. “These socks could provide us with essential data on the recovery process. By showing patients their improvement, for example, we can give positive feedback to support their recovery.”
Moreover, because a feedback app will be linked to the socks, patients could gain greater autonomy over their own recovery and require less supervision by a physical therapist.
Brink said an important differentiator between the AO Socks for Customized Weight Bearing and other smart wearables available on the market is that their application is pure rehabilitative, rather than for sports activity. Although the project is still in its early stages—deciding exactly which parameters to measure, which sensors to use and basic investigation of the number of sensors required and where they will be positioned in the socks—Brink believes it has the potential to transform clinicians’ thinking about weight bearing after surgery for fractures of the pelvis and lower extremity.
“By using the socks as a reliable tool to measure weight bearing in all kinds of patients with fixed fractures, we can ultimately improve knowledge about after-treatment and improve education across the AO,” he said. “Today, we are still using weight bearing protocols developed 50 years ago. I predict that within ten years, based on our knowledge about permissive weight bearing, after-treatment protocols will be completely rewritten.”
Besides Brink, other key collaborators in the project are MUMC colleagues: assistant Prof Martijn Poeze (trauma surgeon); assistant professor of movement and science Kenneth Meyer; industrial designers Jos Aarts, Enrico Toffoli and Jolien Dabbekousen of Instrument Engineering Development and Evaluation (IDEE); assistant professor of biomedical signal and image processing and systems theory Joel Karel; and Prof Panos Markopoulos, User Centered Engineering Group, Eindhoven University of Technology (NL).
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