USE AND USABILITY OF CUSTOM-MADE KNEE-ANKLE-FOOT ORTHOSES IN POLIO SURVIVORS WITH KNEE INSTABILITY: A CROSS-SECTIONAL SURVEY

Abstract

Objective

To investigate the use of custom-made knee-ankle-foot orthoses in daily life and differences in usability factors of knee-ankle-foot orthoses between users and discontinued users.

Design

Cross-sectional survey study.

Subjects

A total of 163 polio survivors provided with a knee-ankle-foot orthosis at an outpatient clinic of a university hospital.

Methods

Use and usability of knee-ankle-foot orthoses in daily life were assessed with a postal questionnaire. Usability factors were formulated using the International Organization for Standardization (ISO) 9241-11 standard.

Results

A total of 106 respondents (65%) returned the questionnaire. Of these, 98 were eligible for analysis. Seventy-four respondents (76%) reported using their knee-ankle-foot orthosis. Compared with discontinued users (24%), users experienced more limitations when walking without an orthosis ( p = 0.001), were more often experienced with wearing a previous orthosis ( p < 0.001) and were more often prescribed with a locked rather than a stance-control knee-ankle-foot orthosis ( p = 0.015). Furthermore, users reported better effectiveness of their knee-ankle-foot orthosis ( p < 0.001), more satisfaction with goals of use and knee-ankle-foot orthosis-related aspects ( p < 0.001).

Conclusion

The majority of polio survivors used their custom-made knee-ankle-foot orthoses in daily life. Factors related to continued use, such as walking ability without orthosis, expectations of the orthosis, previous orthosis experience and type of knee-ankle-foot orthosis provided, should be considered and discussed when prescribing a knee-ankle-foot orthosis in polio survivors.

LAY ABSTRACT

Knee-ankle-foot orthoses for knee instability are commonly prescribed in polio survivors to enhance safe ambulation. This survey investigated the use of knee-ankle-foot orthoses in daily life and differences in factors of usability between users and discontinued users. Seventy-six percent of polio survivors used their custom-made knee-ankle-foot orthosis in daily life. Important usability factors that were related to continued use of knee-ankle-foot orthoses were low perceived walking ability status without orthosis, previous orthosis experience, high perceived effectiveness and satisfaction when standing and walking with a knee-ankle-foot orthoses. When prescribing a custom-made knee-ankle-foot orthoses it is important to consider these factors and discuss goals of use and expected benefits of the knee-ankle-foot orthoses with the patient, especially in relation to perceived walking limitations and activities in daily life.