LAB: Weight Bearing Demo

Overview

Weight-bearing restrictions specify the amount of weight allowed on the legs during recovery from injury or surgery. Restrictions range from non-weight-bearing (most restrictive) to full weight-bearing (most permissive), with orthopedic surgeons determining appropriate levels based on bone and tissue status.

Weight-Bearing Status Categories

Status	Weight Allowed	Description	Technique
Non-Weight-Bearing (NWB)	0%	No weight on affected leg	Weight transmitted through arms; leg kept in slight bend to avoid catching foot
Toe Touch Weight-Bearing	0% (balance only)	Toe touches ground for balance	All weight through arms; toe provides tripod stability
Foot Flat Weight-Bearing	0% (balance only)	Entire foot flat for balance	All weight through arms; foot provides broader base of support
Partial Weight-Bearing (PWB)	Specified percentage (e.g., 50%)	Limited weight on affected leg	Weight distributed between arms and affected leg per surgeon's orders
Weight-Bearing As Tolerated (WBAT)	Variable, based on comfort	Patient adjusts weight based on pain	Use assistive device as needed; typically a progression from PWB
Full Weight-Bearing (FWB)	100%	Normal weight distribution	No restrictions; both legs bear full weight

Teaching Methods for Partial Weight-Bearing

Scale method: Patient steps on scale to monitor weight (e.g., 140 lb patient keeps at or below 70 lbs for 50% PWB)
Repetition training: Patient practices with scale feedback until they learn how the percentage feels
Pressure mat technology: Mat set to specific weight threshold; beeps if patient exceeds limit
Shoe sensors: Alternative monitoring device that can be placed in footwear
Scale remains most common teaching tool in clinical settings

Clinical Considerations

Leg positioning for NWB: Hip and knee kept slightly bent to prevent foot catching; alternatively, keep femur perpendicular to ground for ankle fractures to avoid hip flexor tightness
Surgeon determines restrictions: Orthopedic surgeon assesses bone, muscle, and ligament status to recommend appropriate weight-bearing level
Assistive devices: Canes, walkers, or parallel bars used to transmit weight through arms during restricted weight-bearing
Hand placement: Hands must be positioned in front of body regardless of assistive device used
WBAT progression: Patient may walk with or without assistive device; gingerly gait common when unsupported