A systematic review of questionnaires to assess patient satisfaction with limb orthoses

Bettoni, Elisa; Ferriero, Giorgio; Bakhsh, H.; Bravini, Elisabetta; Massazza, Giuseppe; Franchignoni, Franco

doi:10.1177/0309364614556836

Cited by 46 publications

(47 citation statements)

References 116 publications

(346 reference statements)

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“… 32–34 Also a systematic review of questionnaires used to assess patient satisfaction with orthoses for any limb found that 63% of the 106 included papers used questionnaires developed for the specific study rather than validated measures, supporting our findings on this aspect of the evidence. 35 …”

Section: Discussionmentioning

confidence: 99%

Systematic review of the evidence on orthotic devices for the management of knee instability related to neuromuscular and central nervous system disorders

et al. 2017

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ObjectivesTo assess the effectiveness of orthotic devices for the management of instability of the knee in adults with a neuromuscular disorder or central nervous system disorder.DesignA systematic review of primary studies.SettingCommunity.ParticipantsAdults with a neuromuscular disorder or central nervous system disorder and impaired walking ability due to instability of the knee.InterventionsOrthoses with the clinical aim of controlling knee instability, for example, knee-ankle-foot orthoses, ankle-foot orthoses and knee orthoses or mixed design with no restrictions in design or material.Primary and secondary outcome measuresCondition-specific or generic patient-reported outcome measures assessing function, disability, independence, activities of daily living, quality of life or psychosocial outcomes; pain; walking ability; functional assessments; biomechanical analysis; adverse effects; usage; patient satisfaction and the acceptability of a device; and resource utilisation data.ResultsTwenty-one studies including 478 patients were included. Orthotic devices were evaluated in patients with postpolio syndrome, poststroke syndrome, inclusion body myositis and spinal cord injury. The review included 2 randomised controlled trials (RCTs), 3 non-randomised controlled studies and 16 case series. Most were small, single-centre studies with only 6 of 21 following patients for 1 year or longer. They met between one and five of nine quality criteria and reported methods and results poorly. They mainly assessed outcomes related to gait analysis and energy consumption with limited use of standardised, validated, patient-reported outcome measures. There was an absence of evidence on outcomes of direct importance to patients such as reduction in pain and falls.ConclusionsThere is a need for high-quality research, particularly RCTs, of orthotic devices for knee instability related to neuromuscular and central nervous system conditions. This research should address outcomes important to patients. There may also be value in developing a national registry.Registration number systematic reviewPROSPERO (CRD42014010180).

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Section: Discussionmentioning

confidence: 99%

Systematic review of the evidence on orthotic devices for the management of knee instability related to neuromuscular and central nervous system disorders

et al. 2017

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“…4,17,21 A systematic review of questionnaires that was used to assess patient satisfaction with any limb orthoses found that 63% of the 106 included papers used questionnaires that had been developed for the specific study rather than validated measures, indicating that our findings related to orthoses for knee instability is a broader issue in the field. 79 …”

Section: Findings In the Context Of Other Studiesmentioning

confidence: 99%

Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: systematic review, qualitative study, survey and costing analysis

O’Connor

McCaughan

McDaid

et al. 2016

Health Technol Assess

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BackgroundPatients who have knee instability that is associated with neuromuscular disease (NMD) and central nervous system (CNS) conditions can be treated using orthoses, such as knee–ankle–foot orthoses (KAFOs).ObjectivesTo assess existing evidence on the effectiveness of orthoses; patient perspectives; types of orthotic devices prescribed in the UK NHS; and associated costs.MethodsQualitative study of views of orthoses users – a qualitative in-depth interview study was undertaken. Data were analysed for thematic content. A coding scheme was developed and an inductive approach was used to identify themes. Systematic review – 18 databases were searched up to November 2014: MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, Cumulative Index to Nursing and Allied Health, EMBASE, PASCAL, Scopus, Science Citation Index, BIOSIS Previews, Physiotherapy Evidence Database, Recal Legacy, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Health Technology Assessment database, Cochrane Central Register of Controlled Trials, Conference Proceedings Citation Index: Science, Health Management Consortium, ClinicalTrials.gov, International Clinical Trials Registry Platform and National Technical Information Service. Studies of adults using an orthosis for instability of the knee related to NMD or a CNS disorder were included. Data were extracted and quality was assessed by two researchers. Narrative synthesis was undertaken. Survey and costing analysis – a web survey of orthotists, physiotherapists and rehabilitation medicine physicians was undertaken. Telephone interviews with orthotists informed a costing analysis.ResultsQualitative study – a total of 24 people participated. Potential for engagement in daily activities was of vital importance to patients; the extent to which their device enabled this was the yardstick by which it was measured. Patients’ prime desired outcome was a reduction in pain, falls or trips, with improved balance and stability. Effectiveness, reliability, comfort and durability were the most valued features of orthoses. Many expressed frustration with perceived deficiencies in service provision relating to appointment and administrative systems and referral pathways. Systematic review – a total of 21 studies (478 participants) were included of people who had post-polio syndrome, inclusion body myositis, were post stroke or had spinal cord injury. The studies evaluated KAFOs (mainly carbon fibre), stance control KAFO and hip KAFOs. All of the studies were at risk of bias and, in general, were poorly reported. Survey and costing analysis – in total, 238 health-care professionals responded. A range of orthoses is prescribed for knee instability that is related to NMD or CNS conditions, approximately half being custom-made. At least 50% of respondents thought that comfort and confidence in mobility were extremely important treatment outcomes. The cost of individual KAFOs was highly variable, ranging from £73 to £3553.ConclusionsVarious types of orthoses are used in the NHS to manage patients with NMD/CNS conditions and knee instability, both custom-made and prefabricated, of variable cost. Evidence on the effectiveness of the orthoses is limited, especially in relation to the outcomes that are important to orthoses users.LimitationsThe population included was broad, limiting any in-depth consideration of specific conditions. The response rate to the survey was low, and the costing analysis was based on some assumptions that may not reflect the true costs of providing KAFOs.Future workFuture work should include high-quality research on the effectiveness and cost-effectiveness of orthoses; development of a core set of outcome measures; further exploration of the views and experiences of patients; and the best models of service delivery.Study registrationThis study is registered as PROSPERO CRD42014010180. The qualitative study is registered as Current Controlled Trials ISRCTN65240228.FundingThe National Institute for Health Research Health Technology Assessment programme.

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“…Walking distance 1 (improved) Walking speed 0 (no difference) Sensation of recurvatum 2 (much improved) Self-confidence when walking 1 (improved) Safety when walking 2 (much improved) *Subjective gait parameters were rated without and with the KAFO as: "much improved" (+2), "improved" (+1), "no difference" (0), "worse" (-1), "much worse" (-2) (15,19), and only scored by patients.…”

Section: Resultsmentioning

confidence: 99%

“…The Quebec User Evaluation of Satisfaction with assistive Technology (QUEST) was used to measure patient satisfaction with the orthosis. This questionnaire comprises 12 satisfaction items (8 questions about the orthotic device, its dimensions, its weight, whether it was easy to adjust, its safety and security, its durability, whether it was easy to use, comfort, and effective ness, and 4 questions about the services involved: its delivery, repairs and maintenance, and the professional services and fol low up services), where all the responses to these items give a quantitative score (19,34), as follows: 1: "not satisfied at all"; 2: "not very satisfied"; 3: "more or less satisfied"; 4: "quite satisfied"; and 5: "very satisfied".…”

Section: Secondary Outcomesmentioning

confidence: 99%

“…Stepbystep analysis can be useful to define the main cause of GR and choose the best treatment (18). Studies on orthotic devices for GR have been conducted on AFO and KAFO users (1), the use of knee orthoses (Swedish knee cages) has been assessed (19), and the effectiveness of AFOs vs KAFOs has been compared (20,21). To assess the effectiveness of KAFO treatment, some authors have analysed the improvement in gait parameters (20)(21)(22)(23)(24), while others have studied energy savings (13,(25)(26)(27)(28).…”

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confidence: 99%

See 1 more Smart Citation

Knee-ankle-foot orthoses for treating posterior knee pain resulting from genu recurvatum: Efficiency, patients' tolerance and satisfaction

Requier¹,

Bensoussan²,

Mancini³

et al. 2018

J Rehabil Med

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A systematic review of questionnaires to assess patient satisfaction with limb orthoses

Cited by 46 publications

References 116 publications

Systematic review of the evidence on orthotic devices for the management of knee instability related to neuromuscular and central nervous system disorders

Systematic review of the evidence on orthotic devices for the management of knee instability related to neuromuscular and central nervous system disorders

Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: systematic review, qualitative study, survey and costing analysis

Knee-ankle-foot orthoses for treating posterior knee pain resulting from genu recurvatum: Efficiency, patients' tolerance and satisfaction

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