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  • How do orthopaedic surgeons and rehabilitation professionals interpret and assess ‘toe touch’ weight bearing and ‘partial’ weight bearing status in the rehabilitation setting?

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Original article
How do orthopaedic surgeons and rehabilitation professionals interpret and assess ‘toe touch’ weight bearing and ‘partial’ weight bearing status in the rehabilitation setting?
  1. Stephen G Thompson,
  2. Rhodri D Phillip,
  3. Andrew Roberts
  1. Defence Medical Rehabilitation Centre, Headley Court, Epsom, United Kingdom
  1. Correspondence to Stephen G Thompson; stephen.thompson84{at}gmail.com

Abstract

Aim To compare the interpretation of toe touch weight bearing (TTWB) and partial weight bearing (PWB) among orthopaedic surgeons, rehabilitation professionals and patients.

Methodology 78 consultant and middle-grade orthopaedic surgeons in the UK completed a questionnaire. 64 rehabilitation professionals (including physiotherapists) at Defence Medical Rehabilitation Centre Headley Court were also recruited. Both groups provided their interpretation of TTWB and PWB as a percentage of total body weight (%TBW). Each rehabilitation professional, then applied what they interpreted to be TTWB and PWB using a Lasar Posture weighing device. The predicted values were compared with the actual values demonstrated.

Results There was no significant difference between orthopaedic surgeons and rehabilitation professionals in their interpretation of TTWB and PWB, however there was a wide range of responses. There was a significant difference between the predicted %TBW and the actual values demonstrated by the ‘educated patient’ (mean difference 4.8 (TTWB) and 22.9 (PWB)).

Conclusion Healthcare professionals vary greatly in their interpretation of the terms TTWB and PWB. Therefore, for a consistency in rehabilitation delivery the terms should not be used in isolation without a further descriptor. Static measures of weight application are lower than people think they are applying. We encourage the use of loading practice with a scale to reassure and educate patients.

  • Rehabilitation
  • Fracture
  • Gait analysis
  • Lower limb quadrant related to injuries

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjsem-2017-000326

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    Footnotes

    • Contributors DMRC Headley Court rehabilitation staff, Orthopaedic Surgeons taking the time to complete the survey. SGT is the guarantor of this study.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Ethics approval In accordance with Ministry of Defence (MoD) research ethics guidelines, this study was exempt from requiring formal MoD ethical approval.