Partload - further guidelines for partial weight-bearing
Partial weight-bearing after lower extremity injury lacks clear guidelines. Using 3D motion capture and OpenSim we will quantify internal knee and hip joint forces during level-ground and stair walking to inform dosing in rehabilitation.
Factsheet
- Schools involved School of Health Professions
- Institute(s) Physiotherapy
- Research unit(s) Fussbiomechanik und Technologie
- Funding organisation Others
- Duration 01.11.2022 - 31.12.2024
- Head of project Prof. Dr. Patric Eichelberger
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Project staff
Michael Streit
Philippe Bähler - Keywords partial weight-bearing, gait analysis, musculoskeletal modeling, level-ground walking, staircase walking
Situation
Unilateral partial weight-bearing is commonly prescribed after major injury or surgery at the lower extremity. It aims to optimize the conditions for bone and soft tissue healing and preventing implant failures. The spectrum in rehabilitation concerning the degree, timing and duration of partial weight-bearing to support the healing process is widespread and there is no agreed recommendation. Patients are commonly taught to adhere to a prescribed level of partial weight-bearing by receiving feedback through body scales or more advanced tools like force measurement insoles. While the approach has been shown to work quite well for static conditions like standing, adherence to a certain maximum load gets far more difficult during dynamic activities like walking. In addition, internal joint forces can be more than three times higher than those applied externally due to muscle contractions. Although internal knee and hip joint forces have been measured with instrumented implants, there is a lack of data about internal joint loads during partial weight-bearing conditions.
Course of action
Nowadays, musculoskeleteal models allow estimating joint and muscle forces from 3D motion capture data without the need of using invasive instrumented implants. This allows to examine systematically the effects of partial weight-bearing conditions on the musculoskeletal system in a larger sample of participants and different movement tasks. Therefore, a cross-sectional study with healthy participants undergoing standard gait analysis in partial weight-bearing conditions during level-ground and staircase walking will be conducted. Musculoskeletal modeling with OpenSim will subsequently serve to estimate internal joint loads of the lower extremity.
Looking ahead
Deepened knowledge about internal joint and muscle forces during partial weight-bearing scenarios will support informed decisions when designing protocols for dosing loads in rehabilitation after lower extremity injury or surgery.
