TY  - JOUR
AU  - Wolf, Milan Anton
AU  - Sauerwald, Leon
AU  - Kosmalla, Felix
AU  - Daiber, Florian
AU  - Krüger, Antonio
AU  - Landgraeber, Stefan
PY  - 2024
DA  - 2024/8/16
TI  - Implementation and Evaluation of a Gait Training Assistant for the Use of Crutches: Usability Study
JO  - JMIR Hum Factors
SP  - e51898
VL  - 11
KW  - telerehabilitation
KW  - orthopedics
KW  - digital gait trainer
KW  - orthopedic
KW  - gait
KW  - movement
KW  - walk
KW  - walking
KW  - crutch
KW  - crutches
KW  - sensor
KW  - sensors
KW  - rehabilitation
KW  - usability
KW  - digital health
KW  - physiotherapy
KW  - physical therapy
KW  - telehealth
KW  - telemedicine
KW  - eHealth
KW  - virtual
KW  - locomotor
KW  - locomotion
AB  - 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. 
SN  - 2292-9495
UR  - https://humanfactors.jmir.org/2024/1/e51898
UR  - https://doi.org/10.2196/51898
DO  - 10.2196/51898
ID  - info:doi/10.2196/51898
ER  -