背景:下肢外科手术通常需要拐杖负重作为康复过程的一部分。骨科选择性手术使患者能够在受控的术前环境中学习正确使用拐杖。数字辅助系统可以安全地规避技术人员的短缺以及可能需要的任何联系限制。
目的:将评估新开发的步态训练助手(GTA)用于拐杖的可用性。将由数字教练训练使用拐杖的干预组与由物理治疗师常规训练使用拐杖的对照组进行比较。
方法:作为新型GTA开发和实施的一部分,14名患者通过在接受现场反馈的同时完成特定练习,学会了用拐杖走路。它们的运动由深度传感器检测并实时评估。具体参数(步长、同步运动,拐杖角度,和拐杖到脚的距离)与物理治疗师训练使用拐杖的对照组(n=14)进行比较。干预组也由物理治疗师进行评估。在研究结束时,患者填写问卷以评估系统的可用性(Brooke的系统可用性量表评分)和患者满意度。
结果:所有接受新型GTA训练的患者都能够正确使用拐杖。干预组显示出明显更好的拐杖角度值(平均-6.3°,SD3.5°与平均值-12.4°,SD4.5°;P<.001)和拐杖位置(平均3.3,SD5.1cm与平均-8.5,SD4.9cm;P=.02)。两组都报告说,他们对使用拐杖充满信心,能够遵循指示,享受培训。尽管大多数人(12/14,86%)更喜欢物理治疗,而不是纯粹的数字治疗,大多数参与者喜欢使用该系统(13/14,93%),并有兴趣尝试其他数字助理(11/14,79%)。GTA的可用性被大多数患者(9/14,64%)评为高于平均水平。
结论:新设计的GTA是一种安全的拐杖教学方法,在统计学上优于物理治疗师的训练。即使患者更喜欢与物理治疗师互动,而不是纯粹的数字方法,数字设备提供了一个安全和激励的机会来学习基本的运动技能的康复。
BACKGROUND: Surgical procedures on the lower extremities often require weight-bearing on crutches as part of the rehabilitation process. Orthopedic elective procedures enable patients to learn the correct use of crutches in a controlled preoperative setting. Digital assistance systems can safely circumvent a shortage of skilled staff and any contact restrictions that may be necessary.
OBJECTIVE: The usability of a newly developed gait training assistant (GTA) for the use of crutches will be evaluated. An intervention group trained to use crutches by the digital trainer will be compared with a control group trained to use crutches conventionally by a physiotherapist.
METHODS: As part of the development and implementation of a novel GTA, 14 patients learned to walk with crutches by completing specific exercises while receiving live feedback. Their movements were detected by a depth sensor and evaluated in real time. Specific parameters (step length, synchronous movement, crutch angle, and crutch distance to the feet) were compared with a control group (n=14) trained to use crutches by physiotherapists. The intervention group was also assessed by a physiotherapist. At the end of the study, the patients completed questionnaires to evaluate the usability of the system (Brooke\'s System Usability Scale score) and patient satisfaction.
RESULTS: All patients trained by the novel GTA were able to use crutches correctly. The intervention group showed significantly better values for crutch angle (mean -6.3°, SD 3.5° vs mean -12.4°, SD 4.5°; P<.001) and crutch position (mean 3.3, SD 5.1 cm vs mean -8.5, SD 4.9 cm; P=.02). Both groups reported that they felt confident in the use of crutches, were able to follow the instructions, and enjoyed the training. Even though the majority (12/14, 86%) preferred physical therapy over a purely digital approach, most participants enjoyed using the system (13/14, 93%) and were interested in trying out other digital assistants (11/14, 79%). The usability of the GTA was rated above average by the majority (9/14, 64%) of the patients.
CONCLUSIONS: The newly designed GTA is a safe method of teaching the use of crutches and is statistically superior to training by a physiotherapist. Even if patients prefer interaction with a physiotherapist over a purely digital approach, digital devices provide a safe and motivating opportunity to learn the essential locomotor skills for rehabilitation.