Characterizing accuracy, retention, and dose-response of an 18-session real-time gait biofeedback program following anterior cruciate ligament reconstruction.
Sergio A Lemus, Annika Kullstam, Hayley P Smitheman et al.
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In 30 seconds
This randomized controlled trial characterized accuracy, retention, and training dose in 13 people who had completed rehabilitation after anterior cruciate ligament reconstruction and showed reduced involved-limb loading during walking. Participants received 18 sessions of bilateral real-time gait biofeedback over 6 weeks, targeting a first peak vertical ground reaction force of 1.15 body weight. Target accuracy rose from approximately 13% in session 1 and plateaued at 20–25% by session 12. Involved-limb loading was higher than baseline at retention testing from session 3 onward, and the median effective dose was 5 sessions (95% confidence interval: 3-14 sessions).
Key findings
- Target accuracy in both limbs increased from ∼13% in session 1 and plateaued at 20-25% by session 12.
- Involved-limb first peak vertical ground reaction force was significantly higher than baseline at retention testing from session 3 through session 18.
- The median effective dose to achieve target loading was 5 sessions (95% confidence interval: 3-14 sessions).
Why it matters
The findings suggest that gait biofeedback can improve involved-limb loading before a full 18-session course is completed, while also showing that precise step-level target attainment remained limited. The reported dose estimate offers a starting point for designing future trials of shorter regimens, but does not establish an optimal clinical schedule or demonstrate broader functional benefit.
What to keep in mind
The study included only 13 participants, limiting the precision and generalizability of its dose and retention estimates.