Effects of a multimodal technology-assisted rehabilitation program in a patient undergoing total ankle and total talus replacement: A paradigmatic case report
Andrea Parente, Nicola Marotta, Andrea Demeco, Daniele Madia, Umile Giuseppe Longo, Antonio Ammendolia, Alessandro de SireObjective
This case report aimed to describe effects in balance, gait, and functional recovery observed during a multimodal technology-assisted rehabilitation program in a patient following total ankle and total talus replacement (TATTR).
Methods
A 59-year-old man (history of ankle fracture-dislocation) developed persistent pain, progressive avascular necrosis of the talus, and advanced ankle osteoarthritis. He underwent TATTR on January 19th, 2025. Then, he underwent a rehabilitation program combined joint mobility recovery, progressive strengthening, proprioceptive training using the Pro-Kin 252 system, gait retraining on an antigravity treadmill, and visual-feedback gait optimization with the Walker View device. We assessed Berg Balance, Tinetti, Barthel Index, EQ-5D, stabilometric variables, gait parameters, and passive ankle range of motion at baseline (T0), 1 month (T1), 3 months (T2), and 5 months (T3).
Results
Overall, clinical outcomes improved from baseline to the 5-month follow-up; stabilometric analysis showed marked reductions in eyes-closed ellipse area and perimeter from T0 to T3 (Area T0: 318 mm 2 ; T3: 77 mm 2 ; Perimeter T0: 742.37 mm; T3: 555.27 mm). Berg Balance Scale increased from 30 to 56, Tinetti total score from 9 to 29, EQ-5D index from 0.169 to 1.0, and Barthel Index from 70 to 100. Gait parameters also improved, with left step length increasing from 39 cm to 50 cm and left contact time decreasing from 1.01 s to 0.84 s.
Conclusions
This case report suggested that a tailored multimodal rehabilitation program supported by advanced technologies might be associated with improvements in balance, gait, and functional independence after TATTR.