Improving partial weight bearing compliance with a smart insole: Validity, reliability, and feasibility study

Area of Science:

• Orthopedics
• Rehabilitation Engineering
• Biomedical Devices

Background:

• Partial weight bearing (PWB) is crucial for lower-extremity orthopedic surgery recovery.
• Patient compliance with PWB restrictions, especially at home, is often challenging.
• A smart insole system offers remote monitoring and real-time feedback to improve PWB adherence.

Purpose of the Study:

• To validate and assess the reliability of a smart insole system for measuring weight-bearing loads.
• To investigate the feasibility of the smart insole system in enhancing PWB compliance during home rehabilitation.

Main Methods:

• The study involved a two-phase design: clinical testing for validity/reliability and a randomized controlled trial for feasibility.
• Validity and reliability were tested against a force plate using simultaneous load measurements.
• Twelve patients undergoing talar osteochondral lesion surgery were randomized into feedback (FB) and non-feedback (NFB) groups for remote home monitoring.

Main Results:

• The smart insole demonstrated high reliability (ICC: 0.97) and excellent agreement with force plate measurements (R²=0.9175).
• The feedback group exhibited significantly higher compliance with prescribed partial weight-bearing thresholds compared to the non-feedback group.

Conclusions:

• The smart insole system is a valid and reliable tool for accurately measuring weight-bearing loads in rehabilitation.
• Continuous remote monitoring and real-time feedback from the insole system effectively improve PWB compliance.
• This technology supports critical postoperative recovery by ensuring adherence to weight-bearing protocols.