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SuspendedNCT04732884Updated Oct 22, 2024

Evaluation of the Effect of Biofeedback on Osseous Union Using Pedobarography After Mid- and Hindfoot Arthrodesis

An interventional study of Smartsens, Gelenic AG; with biofeedback and Smartsens, Gelenic AG; without biofeedback in Complication of Surgical or Medical Care, sponsored by Prof. Dr. med. Arno Frigg. Suspended at 1 site in Switzerland. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-10-22.

Sponsored by Prof. Dr. med. Arno Frigg · Not applicable, Interventional, and Other

Why this study was suspended
Trial was suspended for technical reasons
Phase
Not applicable
Study type
Interventional
Enrollment
216
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The current study aims at evaluating the effect of biofeedback of correct partial weight bearing on the rate of osseous non-union compared to conventional patient instruction without biofeedback.

Read the detailed description

Post-traumatic situations or instabilities of other aetiology at the level of the foot can lead to painful degenerative arthritis that necessitates surgical arthrodesis for pain relief. Surgical arthrodesis in this region though is associated with a high risk of osseous non-union (depending on the exact location up to 40%) despite standardized preparation and fixation techniques. The development of osseous non-union is associated with certain patient characteristics like active smoking, nutrition etc. Compliance to partial weight-bearing during the early postoperative phase is another contributing factor.

The current study aims at evaluating the effect of biofeedback of correct partial weight bearing on the rate of osseous non-union compared to conventional patient instruction without biofeedback.

All patients will postoperatively be provided with a lower- leg unloading orthosis furnished with a weight sensor that will - according to randomization - give feedback if a predefined weight threshold has been crossed or just measure weight-bearing without feedback.

02

Conditions studied

  • Complication of Surgical or Medical Care

Keywords

  • mid- and hindfoot surgical arthrodesis
  • osseous non-union
03

In context

Lead sponsor

This is the only study on the registry with Prof. Dr. med. Arno Frigg as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Indication for hind- or midfoot arthrodesis
  • Informed Consent
  • Body weight \< 90kg (according to Smartsens manufacturers recommendations)

Exclusion criteria

Exclusion Criteria:

  • Physical or mental inability to follow weight-bearing recommendations (e.g. dementia, neurologic disease, upper extremity pathology)
  • Participation in a potentially interfering interventional trial during the last 30 day or before wash-out of any trial medication (e.g. steroids, medications affecting bone metabolism etc.)
  • Previous infection at the intended surgical site
  • Body weight > 90kg
  • Pregnancy
05

Study design

Phase
Not applicable
Primary purpose
Other
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
216 participants (estimated)

Study arms

  • Experimental
    Weight sensor with biofeedback

    Activation of the feedback function of the weight-bearing sensor as mean to possibly enhance compliance to weight-bearing instructions postoperative.

    Device: Smartsens, Gelenic AG; with biofeedback

  • Experimental
    Weight sensor without biofeedback

    Standard patient education considering postoperative weight-bearing parameters and measurement of actual weight-bearing with the sensor.

    Device: Smartsens, Gelenic AG; without biofeedback

Interventions

  • DeviceSmartsens, Gelenic AG; with biofeedback

    The Smartsens is a CE certified 4-cell load sensor integrated in an insole that can be placed in any orthosis or cast. A threshold (10-50kg) can be defined at which - if higher loads are measured - an audio signal warns the patient of overloading (biofeedback). The device additionally registers loads from 0-100kg continuously.

    Also known as: Weight sensor with biofeedback

  • DeviceSmartsens, Gelenic AG; without biofeedback

    Patients will not be warned by an audio signal in case of overloading. The device registers loads from 0-100kg continuously.

    Also known as: Weight sensor without biofeedback

06

What researchers measure

Primary outcomes

  1. Evaluation of the influence of weight bearing an resting time on the development of osseous non-union after surgical arthrodesis at the level of the mid- and hindfoot.

    The primary outcome is an analysis of the rate of non-unions after mid- and hindfoot arthrodesis comparing a sensor the two patient arms with activated vs non-activated biofeedback. The rate of osseous non-unions defined as CT-morphologic union \<30% of the joint surface at 3 months in relation to the provision of biofeedback.

    Time frame: 3 months

Secondary outcomes

  1. Compliance i.e. adherence to weight bearing recommendations (≤ 15kg charge) with and without biofeedback.

    All patients will be asked to wear the orthosis with integrated sensor all day long including resting times. They are furthermore instructed to follow partial weight-bearing with 15kg (for 6 weeks). The device will record load and quantity of steps over time. In the first group, a biofeedback in form of an audio-signal will warn the patient if treatment recommendations like partial weight bearing are not followed. The control intervention will be pure instruction followed by measurements. Control patients will not receive biofeedback upon transgression of recommendations.

    Time frame: 6 weeks

  2. Compliance i.e. adherence to resting time recommendations (≥ 80% of time) with and without biofeedback.

    All patients will be asked to wear the orthosis with integrated sensor all day long including resting times. They are furthermore instructed to reduce their activity with 80% resting time. The device will record load and quantity of steps over time. In the first group, a biofeedback in form of an audio-signal will warn the patient if treatment recommendations like resting times are not followed. The control intervention will be pure instruction followed by measurements of load and quantity of steps. Control patients will not receive biofeedback upon transgression of recommendations.

    Time frame: 6 weeks

  3. Consumption of analgesic medication after surgery

    Consumption of analgesic medication following WHO grading. Data will be collected at any scheduled (2 and 6 weeks, 3 and 12 months) or unscheduled follow-up visits.

    Time frame: 12 months

  4. Patient's quality of life after surgery

    Quality of life will be analysed by using EuroQuality of Life Five Dimensions (EQ5D-5L) questionnaire at baseline and after 3 months and 12 months. The descriptive system comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The EQ VAS records the patient's self-rated health on a vertical visual analogue scale, where the endpoints are labelled 'The best health you can imagine' and 'The worst health you can imagine'.

    Time frame: 12 months

  5. Patient's satisfaction

    Patient satisfaction will be documented after 2 weeks, 6 weeks, 3 months and 12 months by using net promotor score (NPS). NPS is the percentage of customers rating their likelihood to recommend the "service" to a friend or colleague as 9 or 10 ("promoters") minus the percentage rating this at 6 or below ("detractors") on a scale from 0 to 10.

    Time frame: 12 months

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Study locations

1 site
  • FussZentrumHirslanen
    Zürich, 8032, Switzerland
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Oct 22, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04732884
Lead sponsor
Prof. Dr. med. Arno Frigg
Responsible party
Prof. Dr. med. Arno Frigg (Prof. Dr. med., Klinik Hirslanden, Zurich) — Sponsor-investigator
First posted
Feb 1, 2021
Start date
Sep 25, 2023
Primary completion
Aug 2026 (estimated)
Completion
Jan 2027 (estimated)
Last update
Oct 22, 2024

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is suspended, as verified in Oct 2024. You cannot join it, but the record below documents what was studied.

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