A TRIAL OF A WEARABLE SENSOR-BASED BIOFEEDBACK SYSTEM FOR RESTORING GAIT SYMMETRY AFTER TOTAL KNEE ARTHROPLASTY
DOI:
https://doi.org/10.71000/ppce9260Keywords:
Biofeedback; Gait; Knee Arthroplasty; Motor Learning; Rehabilitation; Wearable Devices; Walking.Abstract
Background: Gait asymmetry is a common and persistent impairment following total knee arthroplasty and is associated with delayed functional recovery, abnormal joint loading, and reduced mobility. Conventional rehabilitation improves strength and range of motion but often fails to adequately restore symmetrical gait patterns. Wearable sensor–based biofeedback offers real-time movement feedback and may enhance motor relearning during postoperative rehabilitation.
Objective: To evaluate the effectiveness of a wearable sensor–based biofeedback system in restoring gait symmetry and improving functional outcomes after total knee arthroplasty compared with conventional rehabilitation alone.
Methods: A randomized controlled trial was conducted on 80 individuals who underwent unilateral total knee arthroplasty. Participants were allocated to a biofeedback-assisted rehabilitation group or a conventional rehabilitation group. The intervention was delivered over six weeks. Primary outcomes included gait symmetry index and step length asymmetry. Secondary outcomes included knee flexion range of motion, Timed Up and Go test, and 6-Minute Walk Test. Assessments were performed at baseline and post-intervention.
Results: The biofeedback group demonstrated significantly greater improvements in gait symmetry index, step length asymmetry, and knee flexion range of motion compared with the control group (p < 0.05). Functional mobility and walking endurance also improved to a significantly greater extent in the biofeedback group. High compliance with the wearable system was observed, and no serious adverse events were reported.
Conclusion: Wearable sensor–based biofeedback integrated into postoperative rehabilitation effectively enhanced gait symmetry, joint mobility, and functional performance following total knee arthroplasty. The findings supported the clinical value of real-time movement feedback as an adjunct to conventional rehabilitation for optimizing functional recovery.
References
Reddy KJ. Motor Rehabilitation and Biofeedback. Innovations in Neurocognitive Rehabilitation: Harnessing Technology for Effective Therapy: Springer; 2025. p. 231-66.
Gordon AM, Nian P, Baidya J, Scuderi GR, Mont MAJTJoA. Randomized controlled studies on smartphone applications and wearable devices for postoperative rehabilitation after total knee arthroplasty: a systematic review. 2025.
Bahadori S. The application of commercial wearable technology and smartphone rehabilitation applications for enhancing individuals’ level of activity after hip replacement surgery: Bournemouth University; 2024.
Rosenberg NJC. Walking Ability After Total Knee Arthroplasty: A Comprehensive Review. 2025;17(2).
Bade MJ, Christiansen CL, Zeni JA, Dayton MR, Forster JE, Cheuy VA, et al. Movement pattern biofeedback training after total knee arthroplasty: a randomized controlled trial. 2025;77(6):732-43.
Almutairi A. Evaluation of an early-stage prototype of a virtual reality-based physiotherapy toolkit for individuals with chronic knee pain: Cardiff University; 2025.
Kaul SM, Maurya NK. Integrating Technology in Physiotherapy: From Virtual Rehab to Wearable Devices: Chyren Publication; 2025.
Gianzina E, Yiannakopoulos CK, Armenis E, Chronopoulos EJJoFM, Kinesiology. Wearable Sensor Assessment of Gait Characteristics in Individuals Awaiting Total Knee Arthroplasty: A Cross-Sectional, Observational Study. 2025;10(3):288.
Codina Barberà M. Gait-Analysis MIoT Platform for Health Assessment. 2024.
Zhai S, Wu R, Du G, Chen X, Liu Y, Zhao J, et al. Smart device–assisted telerehabilitation versus conventional rehabilitation after total nee arthroplasty: a systematic review and meta-analysis. 2025;20(1):1-17.
Abdullah S. Design and Development of Biofeedback Stick Technology (BfT) to Improve the Quality of Life of Walking Stick Users: Birmingham City University; 2023.
Sullivan S. Investigating Biomechanical Adaptations to Personalized Wearable Assistive Devices: University of Illinois at Chicago; 2023.
Paladugu P, Kumar R, Ong J, Waisberg E, Sporn KJJoOS, Research. Virtual reality-enhanced rehabilitation for improving musculoskeletal function and recovery after trauma. 2025;20(1):404.
Fary C, Cholewa J, Abshagen S, Van Andel D, Ren A, Anderson MB, et al. Stepping beyond counts in recovery of total knee arthroplasty: A prospective study on passively collected gait metrics. 2023;23(12):5588.
Sara LK, Lewis CLJHJ. Rehabilitation phases, precautions, and mobility goals following total hip arthroplasty. 2023;19(4):494-500.
PANDA S, BALI SJAdIiP, 2 O. Biomechanics in Physiotherapy. 2025:291-316.
Dereshgi HA, Göse E, Demir D, Ghannam HJJoSSR. Restoring mobility and independence: evaluating the impact of knee exoskeletons in real-world scenarios. 2023;4(1):61-71.
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Copyright (c) 2025 Hafiza Aroofa, Dania Khan, Qurat Ul Ain, Mamoona Tasleem Afzal, Danial Aziz, Aaiza Naeem, Fahad Asim (Author)
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