Use of the ICF to investigate impairment, activity limitation and participation restriction in people using ankle-foot orthoses to manage mobility disabilities

Abstract

This version is available at https://strathprints.strath.ac.uk/56193/ Strathprints is designed to allow users to access the research output of the University of Strathclyde. Unless otherwise explicitly stated on the manuscript, Copyright © and Moral Rights for the papers on this site are retained by the individual authors and/or other copyright owners. Please check the manuscript for details of any other licences that may have been applied. You may not engage in further distribution of the material for any profitmaking activities or any commercial gain. You may freely distribute both the url (https://strathprints.strath.ac.uk/) and the content of this paper for research or private study, educational, or not-for-profit purposes without prior permission or charge.Any correspondence concerning this service should be sent to the Main Text IntroductionAnkle-foot orthoses (AFOs) are externally applied devices that encompass the joints of the ankle and foot. They are used to modify the structure and function of the neuromuscular and skeletal systems [1] and are used to manage mobility disabilities caused by a wide range of conditions such as stroke, cerebral palsy, spina bifida, poliomyelitis and peripheral nerve injury [2][3][4][5][6]. AFOs have been shown to improve timed walking speed, step length and clearance of the toe in the swing phase of gait. [2,3,5,[7][8][9][10][11][12][13][14]. Whilst these outcome measures are valuable in providing evidence for orthotic intervention, they focus on specific aspects of physical activity that can be measured in a gait laboratory. Consequently, they do not provide any information about patients' use of AFOs in their day to day lives or the extent to which use of AFOs is associated with physical, psychological and social well-being. These outcomes are important because they are of value to the patient. Specifically, consideration of psychological well-being is vital because of its relationship with functional outcomes [15,16]. This paper adds to the literature by focusing on AFO use in a real life setting and by incorporating psychological measures to investigate differences in impairment, activity limitation and participation restriction across 3 groups of AFO users; people using AFOs as recommended, people using AFOs differently to recommended; and those not aware of recommendations for use. Use of AFOsTo identify differences in outcomes across these groups, consideration should be given to other factors that could affect AFO use. Seriousness of the underlying health condition has been related to AFO use. Dystrophy did not use their AFOs for the recommended amount of time, with all of these participants using the AFO less than recommended. This was thought to be due to pain and patient reluctance to wear the orthotic devices; however reasons for their reluctance were not formally investigated. In summary, appropriate use of orthoses is important for optimal outcomes. Identification of Health OutcomesA theoretical approach to understanding use of AFOs and their impact on pati...

Development and initial validation of the Orthotic Patient-Reported Outcomes—Mobility (OPRO-M): An item bank for evaluating mobility of people who use lower-limb orthoses

“…The respective proportions reported in the current study and the ABC survey, respectively, were similar for AFOs (87.1%, 81.1%), KAFOs (9.6%, 14.5%), HKAFOs (0.7%, 0.3%), and FES devices (0.7%, 0.1%) [ 58 ]. The health conditions most frequently reported by participants in this study are also identified in the literature as being most relevant to LLO use, including stroke, spinal cord injury, orthopedic conditions, and Charcot-Marie-Tooth disease [ 59 , 60 ]. These findings suggest that the reference sample for the OPRO-M item bank calibration is representative of the population of patients receiving orthotic care in clinical settings.…”

Factors Affecting Compliance with Lower and Upper Extremity Orthoses in Patients with Disability Due to Neurological Diseases

“…In addition, they found that for the use of AFO, it is necessary to evaluate the psychological state of the patients. 21 It was determined that as the disease duration and orthosis prescription duration increased, the rate of leaving the orthosis increased. Although patients may try to use their orthoses at first, they may stop using the orthosis for various reasons later on.…”

Use of lower extremity orthoses in patients with cerebral palsy and related factors

“…As age increased, factors such as increased anxiety and cosmetic concerns may be potential reasons reducing orthosis compliance in patients with CP. McMonagle et al 14 conducted a study and investigated factors affecting AFO use in patients who were over 18 years of age. They found that the participants who did not use AFO had higher anxiety scores compared with those who used it.…”