Postoperative Effects of Somatosensory Foot Training on Balance and Walking Ability in Proximal Femoral Fractures - A Single-case Design Analysis

Q: What was the study’s primary objective?

To assess the impact of postoperative somatosensory foot training on walking balance and speed compared with conventional physical therapy in three patients with proximal femoral fractures.

Q: How was the single-case A-B design implemented?

Phase A used conventional physical therapy interventions, while phase B added somatosensory training; each phase lasted 6 days.

Q: Which measures were used to evaluate walking and balance outcomes?

The Timed Up-and-Go (TUG) test and the 10-m maximum walking speed were used as outcome measures.

Sep 30, 2026

Uploaded by Rainbow Cat

Assess postoperative somatosensory foot training after surgery for proximal femoral fractures using a single-case A-B design. Three patients in their 70s with left proximal femoral fractures were assigned phase A with conventional physical therapy and phase B with added somatosensory training, each lasting 6 days. Outcomes included Timed Up-and-Go (TUG) and 10-m maximum walking speed. PND and Tau-U analyses showed large intervention effects, with significantly shorter TUG times and higher walking speeds in phase B versus phase A (p<0.05).

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Abstract

Objectives and Methods

Outcome Measures and Effect Sizes

Results and Conclusions

Introduction

Clinical Importance of Proximal Femoral Fractures

Somatosensory Inputs and Balance Regulation

Study Rationale and Hypothesis

Method

P H Y S I C A LT H E R A P YR E S E A R C H CASE STUDY Postoperative Effects of Somatosensory Foot Training on Balance and Walking Ability in Proximal Femoral Fractures: A Single-case Design Analysis Tomoki HAKAMATA, PT, PhD1, Junichi SUGANUMA, PT, PhD2, and Kazuhiro CHIDORI PT, PhD2 1)Department of Rehabilitation, Kasai Central Hospital, Japan 2)Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Chubu Gakuin University, Japan ABSTRACT. Objectives: By using a single-case design, we aimed to assess the impact of postoperative somatosensory foot training on walking balance and speed compared with conventional physical therapy interventions in 3 patients with proximal femoral fractures. Methods: This study included 3 patients in their 70s who sustained left proximal femoral fractures due to falls and underwent open reduction and internal fixation or hemiarthroplasty. AnAB-type single-case design was employed, with phase A consisting of conventional physical therapy interventions and phase B involving additional somatosensory training. Each phase lasted for 6 days. The outcome measures included the Timed Up-and-Go (TUG) test and 10-m maximum walking speed. To determine interventional effects, effect sizes were calculated using the percentage of nonoverlapping data (PND) and the Tau-U coefficient. Results: Our PND analysis indicated a large effect size for the TUG and 10-m maximum walking speed outcome measures in all cases. Additionally, the Tau-U analysis showed that all patients exhibited significantly shorter TUG times and higher 10-m maximum walking speeds in phase B compared with phase A (p <0.05). Conclusions: Postoperative somatosensory foot training may be effective in improving walking balance and speed in patients with proximal femoral fractures. Key words: Somatosensory training, Single-case design, Proximal femoral fractures, Timed-Up-and-Go test, Tau-U (Phys Ther Res 28: 225–230, 2025) Introduction Proximal femoral fractures are among the leading causes of hospitalization in older adults, often resulting from falls and are likely to require surgical intervention1) . Patients who undergo surgery for proximal femoral fractures often experience physical impairments such as decreased walking speed2), impaired balance3), reduced ability to perform Received: March 16, 2025 Accepted: July 4, 2025 Advance Publication by J-STAGE: September 11, 2025 Correspondence to: Kazuhiro Chidori. Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Chubu Gakuin University, 2-1 Kirigaoka, Seki, Gifu 501-3993, Japan e-mail: [chidori@chubu-gu.ac.jp](chidori@chubu-gu.ac.jp) [doi: 10.1298/ptr.25-E10349](doi: 10.1298/ptr.25-E10349) This work is licensed under a Creative Commons Attribution 4.0 International License. ©2025 Japanese Society of Physical Therapy activities of daily living4), and muscle weakness5) . Decreased walking ability was observed in approximately 50% of the patients 12 and 24 months after surgery6) . A decrease in walking speed has been associated with an increased risk of falls7) and may lead to a decline in balance ability3) . Additionally, patients with impaired balance are at higher risk of falls, which may lead to re-hospitalization8) . For these reasons, assessing the postoperative improvement in walking balance and walking abilities in patients who sustain proximal femoral fractures from falls and undergo surgery is an important issue in preventing subsequent falls. Human gait and balance adjustments are integrated by the central nervous system based on afferent information from somatosensory inputs9) . Notably, it has been clarified that afferent sensory information from the feet and soles plays an important role in balance regulation10) . In this context, studies have shown that somatosensory training of the feet, which enhances the contribution of somatosensation and promotes perceptual learning, is beneficial for improving balance ab

FAQs

What was the study’s primary objective?

To assess the impact of postoperative somatosensory foot training on walking balance and speed compared with conventional physical therapy in three patients with proximal femoral fractures.

How was the single-case A-B design implemented?

Phase A used conventional physical therapy interventions, while phase B added somatosensory training; each phase lasted 6 days.

Which measures were used to evaluate walking and balance outcomes?

The Timed Up-and-Go (TUG) test and the 10-m maximum walking speed were used as outcome measures.

Sep 30, 2026

Uploaded by Rainbow Cat