Evidence map›Paper›PMID 40523278›Full record

Observational studyJMIR mHealth and uHealth2025

Recovery of Patient-Reported Outcome Measures vs Gait Parameters Obtained by Instrumented Insoles After Tibial and Malleolar Fractures: Prospective Longitudinal Observational Study.

Elke Warmerdam, Marianne Huebner, Caroline Stoll, Andrey Ivanovic Lange, Bergita Ganse

Abstract readObservational Study
In one paragraph

Observational study in JMIR mHealth and uHealth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. [Musculoskeletal research : Trauma surgery and space flight].Unfallchirurgie (Heidelberg, Germany) · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Elke WarmerdamInnovative Implant Development (Fracture Healing), Departments and Institutes of Surgery, Saarland University, Homburg, Germany.ORCID 0000-0002-2343-7761
Marianne HuebnerDepartment of Statistics, Michigan State University, East Lansing, MI, United States.ORCID 0000-0002-9694-9231
Caroline StollInnovative Implant Development (Fracture Healing), Departments and Institutes of Surgery, Saarland University, Homburg, Germany.ORCID 0009-0008-3976-9358
Andrey Ivanovic LangeInnovative Implant Development (Fracture Healing), Departments and Institutes of Surgery, Saarland University, Homburg, Germany.ORCID 0009-0002-4289-958X
Bergita GanseInnovative Implant Development (Fracture Healing), Departments and Institutes of Surgery, Saarland University, Homburg, Germany.ORCID 0000-0002-9512-2910

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNew technologies from the field of mobile health (mHealth) are increasingly used to improve patient monitoring during rehabilitation. While in recent years, mobile phones, health apps, personal digital assistants, and smartwatches opened up new diagnostic and monitoring opportunities for patients, the development of innovative sensor devices, such as instrumented insoles, has now reached a sufficient level of usability with promising opportunities for clinical practice. According to research on the best method for monitoring recovery after musculoskeletal injury or surgery, the Patient-Reported Outcome Measurement Information System (PROMIS) and wearables such as instrumented insoles are among the most promising newer options. However, it is unknown how a patient's health perception and improvements in instrumented insole-derived gait parameters correlate after surgery for tibial or malleolar fractures.

objectiveThis study aimed to compare the longitudinal trajectories in separate PROMIS (sub)scores with gait and further patient-specific parameters, as well as associations between PROMIS scores and gait parameters. It was also aimed to determine the influence of anthropometric parameters and comorbidities.

methodsA total of 85 patients (39 women and 46 men; average age 50.8, SD 17.1 years) requiring surgery after tibial or malleolar fractures were included in this prospective longitudinal observational study. In the hospital and during follow-up visits, the patients completed the PROMIS Global Health and Pain Interference questionnaires. During the same visits, individually fitted instrumented insoles with 16 pressure sensors, an accelerometer, and a gyroscope each were used to assess the maximal force, pressure distribution, and angular velocity during walking with data being recorded at 100 Hz. Statistical analyses were conducted using linear mixed effect models, pairwise Spearman correlation coefficients, and generalized additive models.

resultsThe gait parameters assessed via the instrumented insoles quickly improved during the first 3 months after surgery, followed by a slowing of further improvement. After surgery, the PROMIS scores increased or decreased to extrema that were reached after 6 weeks to 3 months, followed by a return to preinjury values. Between 3 and 6 months, no significant improvements in PROMIS scores were observed. Between 6 months and 1 year, the Physical Health and Mental Health scores still improved significantly (P=.003 in both cases). Men had better Physical Health and lower Pain Interference scores than women (P=.01 and P=.03, respectively). Hypertension had a negative effect on the Physical Health score (P=.03). The associations between the PROMIS score and gait parameters were strongest at approximately 3 months after surgery, predominantly between the Pain Interference score and gait parameters.

conclusionsThe patients' perception improved later than the objective gait parameters obtained by instrumented insoles did. When the gait pattern improved, pain perception correlated with the gait parameters.

trial registrationGerman Clinical Trials Registry DRKS00025108; https://drks.de/search/en/trial/DRKS00025108.

Indexed as

Ankle FracturesFoot OrthosesGaitPatient Reported Outcome MeasuresRecovery of FunctionTibial FracturesAdultAgedFemaleHumansLongitudinal StudiesMaleMiddle AgedProspective Studiesfracturegait parametersgeneralized additive modelhypertensioninstrumented insoleslower legmixed-effects modelspatient-reported outcome measuresPROMISwearable

Identifiers

PMID40523278
PMCPMC12209729

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.