An interventional study of Video Feedback-Supported Gait Training and Conventional Physiotherapy in Bone Lengthening and Gait Disorders, sponsored by Istanbul Aydın University. Not yet recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years to 45 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-07-28.
Sponsored by Istanbul Aydın University · Not applicable, Interventional, and Treatment
This randomized controlled study aims to investigate the effects of adding video feedback-supported gait training to a standard rehabilitation program in individuals undergoing cosmetic bilateral femoral lengthening surgery.
A total of 32 adults aged 18-45 years who undergo cosmetic bilateral femoral lengthening using the Lengthening Over Nail (LON) technique will be included. All surgical procedures will be performed at Private Esencan Hospital. Participants will be monitored at the hospital for the first 6 postoperative days, and the distraction phase will begin on postoperative day 7. After discharge, rehabilitation will continue at BNB Health Services and Consultancy Center.
Participants will be assigned to an intervention group or a control group using block randomization at a 1:1 ratio. Both groups will receive rehabilitation 5 days per week, with each session lasting 50 minutes. The control group will receive 50 minutes of conventional physiotherapy. The intervention group will receive 40 minutes of conventional physiotherapy and 10 minutes of video feedback-supported gait training.
Assessments will be performed before surgery (T0), when approximately 4 cm of lengthening has been achieved (T1), when approximately 8 cm of lengthening has been achieved (T2), and 2 weeks after removal of the external fixator (T3).
The primary outcome will be walking performance assessed using the 10-Meter Walk Test. Secondary outcomes will include lower-extremity function, kinesiophobia, body awareness, quadriceps muscle strength, and pressure pain threshold.
Cosmetic limb-lengthening surgery has become increasingly common among individuals seeking an increase in height. The Lengthening Over Nail (LON) technique reduces the duration of external fixation and provides greater mechanical stability. However, the lengthening process affects not only bone tissue but also muscles, tendons, connective tissues, blood vessels, and the nervous system.
During distraction osteogenesis, approximately 1 mm of lengthening is generally performed each day. The resulting continuous mechanical tension on the soft tissues may lead to quadriceps tightness, reduced knee range of motion, loss of muscle strength, pain, and impaired functional performance. Joint stiffness, muscle-tendon problems, contractures, and alterations in gait may also occur during femoral lengthening. Therefore, intensive and structured rehabilitation is an essential component of the treatment process.
Video feedback allows individuals to observe their own movement patterns, recognize movement errors, and modify their motor strategies. Although visual and video feedback approaches have demonstrated beneficial effects on gait and motor performance in several patient populations, their effects have not been investigated in individuals undergoing cosmetic bilateral femoral lengthening.
This study is designed as a prospective, parallel-group, assessor-blinded randomized controlled trial. A total of 32 participants aged 18-45 years who undergo cosmetic bilateral femoral lengthening using the LON technique will be assigned to two groups through computer-generated block randomization at a 1:1 ratio.
Both groups will participate in rehabilitation sessions 5 days per week, with each session lasting 50 minutes. The control group will receive 50 minutes of conventional physiotherapy. The intervention group will receive 40 minutes of conventional physiotherapy in addition to 10 minutes of video feedback-supported gait training. Conventional physiotherapy will include active and passive range-of-motion exercises, stretching exercises for the quadriceps and hamstring muscles, isometric strengthening exercises, gait training, and neuromuscular electrical stimulation.
During video feedback-supported gait training, participants will be recorded while walking along a 10-meter walkway. Recordings will be obtained in the frontal and sagittal planes. Participants will review their gait videos with the physiotherapist and receive standardized verbal and visual feedback regarding step width, step symmetry, lateral trunk deviation, shoulder alignment, pelvic position, Trendelenburg sign, hip and knee movements, foot contact, and gait rhythm.
Assessments will be conducted before surgery (T0), at approximately 4 cm of lengthening (T1), at approximately 8 cm of lengthening (T2), and 2 weeks after external fixator removal (T3). All assessments will be performed by an outcome assessor who is blinded to group allocation.
The primary outcome will be walking performance measured using the 10-Meter Walk Test. Secondary outcomes will include the Lower Extremity Functional Scale, Tampa Scale for Kinesiophobia, Body Awareness Questionnaire, quadriceps muscle strength measured with a handheld dynamometer, and pressure pain threshold measured with a pressure algometer.
The study will determine whether adding video feedback-supported gait training to conventional physiotherapy provides greater improvements in walking performance, functional status, movement-related fear, body awareness, quadriceps muscle strength, and pressure pain threshold than conventional physiotherapy alone.
381 studies on the registry are indexed under Mobility Limitation; 108 are open to participants now.
This study's planned enrollment of 32 is below the median of 46 across 316 interventional studies indexed under Mobility Limitation.
Browse Mobility Limitation studies →Istanbul Aydın University is the lead sponsor of 70 studies on the registry; 18 are open to participants now.
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Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Participants will receive 40 minutes of conventional physiotherapy and 10 minutes of video feedback-supported gait training per session, 5 days per week throughout the distraction phase.
Behavioral: Video Feedback-Supported Gait Training · Other: Conventional Physiotherapy
Participants will receive 50 minutes of conventional physiotherapy per session, 5 days per week throughout the distraction phase.
Other: Conventional Physiotherapy
Participants will be recorded while walking on a 10-meter walkway in the frontal and sagittal planes. They will review the recordings with the physiotherapist and receive standardized visual and verbal feedback regarding step width, step symmetry, trunk alignment, pelvic position, Trendelenburg sign, lower-extremity movements, foot contact, and gait rhythm. The intervention will be administered for 10 minutes per session, 5 days per week throughout the distraction phase.
Conventional physiotherapy will include active and passive range-of-motion exercises, quadriceps and hamstring stretching, isometric strengthening exercises, gait training, and neuromuscular electrical stimulation. The experimental arm will receive 40 minutes and the active comparator arm will receive 50 minutes per session, 5 days per week throughout the distraction phase.
Change in Walking Speed Assessed by the 10-Meter Walk Test
Walking speed will be assessed on a 14-meter walkway. The first 2 meters will be used for acceleration and the final 2 meters for deceleration. The time required to walk the middle 10 meters at a comfortable speed will be recorded in seconds using a digital stopwatch. Walking speed will be calculated in meters per second. The test will be performed twice, and the mean value will be used. Higher walking speed indicates better walking performance.
Time frame: Baseline (preoperative), postoperative Week 7, postoperative Week 13, and postoperative Week 15.
Lower-Extremity Function
The Lower Extremity Functional Scale consists of 20 items assessing difficulty in performing daily activities. Each item is scored from 0 to 4, producing a total score ranging from 0 to 80. Higher scores indicate better lower-extremity function.
Time frame: Baseline (preoperative), postoperative Week 7, postoperative Week 13, and postoperative Week 15.
Change in Kinesiophobia Assessed With the Tampa Scale for Kinesiophobia
The Tampa Scale for Kinesiophobia is a 17-item self-reported questionnaire assessing fear of movement and reinjury. The total score ranges from 17 to 68. Higher scores indicate greater kinesiophobia.
Time frame: Baseline (preoperative), postoperative Week 7, postoperative Week 13, and postoperative Week 15.
Change in Body Awareness Assessed With the Body Awareness Questionnaire
The Body Awareness Questionnaire is an 18-item self-reported questionnaire assessing attentiveness to normal bodily processes and changes. The total score ranges from 18 to 126. Higher scores indicate greater body awareness.
Time frame: Baseline (preoperative), postoperative Week 7, postoperative Week 13, and postoperative Week 15.
Change in Quadriceps Muscle Strength Assessed With a Handheld Dynamometer
Quadriceps muscle strength will be measured using a MicroFET 2 handheld dynamometer. Participants will be assessed in a seated position with the hip and knee flexed to 90 degrees. Three measurements will be performed, and the mean value will be used. Higher values indicate greater quadriceps muscle strength.
Time frame: Baseline (preoperative), postoperative Week 7, postoperative Week 13, and postoperative Week 15.
Change in Pressure Pain Threshold Assessed With a Pressure Algometer
Pressure pain threshold will be measured over the vastus lateralis using a Baseline dolorimeter. The measurement point will be the midpoint between the greater trochanter and the lateral femoral condyle. Three measurements will be performed, and the mean value in kilograms per square centimeter will be used. Higher values indicate a higher pressure pain threshold and lower pressure sensitivity.
Time frame: Baseline (preoperative), postoperative Week 7, postoperative Week 13, and postoperative Week 15.
Plan to share: No — Individual participant data will not be shared because participant consent for external data sharing was not obtained.
No publications or documents are linked to this record.
Start is estimated for Aug 2026; primary completion for Nov 2026, 3 months later.
Of 198 non-industry interventional studies with no phase under Mobility Limitation, half reached primary completion within 18 months of starting (the median), counting those still running; a quarter within 8 and three quarters within 42. This study's planned 3 months is below that.
Counting every sponsor, half of 203 studies reached it within 18 months; a quarter within 8 and three quarters within 44.
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Istanbul Aydın University