A user-centered qualitative study on experiences with ankle-foot orthoses and suggestions for improved design

Wilk, Dymphy van der; Hijmans, Juha M.; Postema, Klaas; Verkerke, Gijsbertus Jacob

doi:10.1177/0309364616683981

Cited by 21 publications

(17 citation statements)

References 18 publications

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“…Swinnen et al 10 conducted 4 focus groups with 20 patients diagnosed with multiple sclerosis that revealed that stigmatisation, difficulties in putting on their lower limb orthosis (AFO), and aesthetic aspects were implicated in non-use. A focus group with eight AFO users living in the Netherlands to gain insight into importance of device-related activities to AFO users found that participants ranked walking as the most important of 11 different activities 11. However, this latter small-scale study did not include any KAFO users, whose priorities for treatment outcomes may differ.…”

Section: Introductionmentioning

confidence: 98%

Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: qualitative interview study of patient perspectives

et al. 2019

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ObjectivesAdults with knee instability related to neuromuscular disorders or central nervous conditions often experience mobility problems and rely on orthoses to improve function and mobility. Patient views of device effectiveness and acceptability are underexplored. Our study aimed to elicit device users’ perspectives regarding fitting, acceptability, effectiveness and use of orthoses, and identify important treatment outcomes.DesignQualitative descriptive study using in-depth semistructured interviews. Interview transcriptions were coded and thematically analysed, using ‘Framework’.Setting and participantsA purposive sample of 24 adult users of orthotic devices. Nineteen patients were recruited across three National Health Service sites, and five people through charities/patient support groups in England. Half of the participants had been diagnosed with poliomyelitis, and the remainder with multiple sclerosis, Charcot-Marie-Tooth disease, spinal injury or spina bifida, and stroke. The median age of participants was 64.5 years (range 36–80 years).ResultsPatients’ medical condition impacted significantly on daily life. Participants relied on orthotic devices to enable engagement in daily activities. Patient goals for mobility were linked to individual circumstances. Desired treatment outcomes included reduction in pain, trips and falls, with improved balance and stability. Effectiveness, reliability, comfort and durability were the most valued features of orthoses and associated with reported use. Obtaining suitable footwear alongside orthotic devices was a significant concern. Time pressures during device fitting were viewed negatively.ConclusionsOrthotic devices for knee instability play a crucial role in promoting, maintaining and enhancing physical and psychological health and well-being, enabling patients to work, engage in family life and enjoy social activities. Future research should consider how best to measure the impact of orthotic devices on patient quality of life and daily functioning outside the clinic setting, as well as device use and any adverse effects.Trial registration numberThis qualitative study was retrospectively registered as Current Controlled Trials ISRCTN65240228.

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Section: Introductionmentioning

confidence: 98%

Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: qualitative interview study of patient perspectives

et al. 2019

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“…Walking characteristics were similarly changed when wearing the SAS or the AFOs compared with barefoot. Stride and step length decreased, self-selected walking speed in the 10-MWT increased while fast pace decreased, TUG times were similar or increased, and cadence increased with the SAS/AFO relative to the barefoot condition (Table 1, metrics [15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…12 A growing number of studies are implementing user-centered design approaches for orthosis development. [13][14][15] Several studies have used the Functional, Expressive, Aesthetic, and Accessibility (FEA2) model that contrasts the typical medical device design model. The FEA2 model has a user-centered focus and addresses users' broad needs rather than considering only the primary function of the device.…”

Section: Introductionmentioning

confidence: 99%

Development and Initial Evaluation of a Soft Ankle Support for Children With Ankle Impairments

Civil

Orlando

Cunha

et al. 2023

Pediatric Physical Therapy

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Purpose: Develop and initially evaluate a soft ankle support (SAS) garment for children with ankle impairments. Description of Cases: Two participants were evaluated at baseline and interviews with their parent(s) to identify wants and needs for the SAS. The SAS was developed and evaluated via participant report and functional measures in barefoot, ankle-foot orthosis (AFO), and SAS conditions. Outcomes: Children and parents expressed dissatisfaction with AFOs' dimensions, weight, adjustability, comfort, and ease of use. Gait and gross motor function were similar for SAS and AFOs' conditions; however, participants rated the SAS better for weight and bulk, integration with shoes, adjustability, comfort, cost, and washability. Discussion: The SAS and AFOs performed similarly in this initial testing, yet the SAS also met participants' needs across key metrics not well addressed by AFOs. Ankle support devices that meet users' broad needs may support improved adherence and user satisfaction.

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“…The questions were related to factors/subthemes that have been reported to (likely) influence a person’s decision to use TF [ 11 , 19 – 21 ]. Also, some general questions based on experience with TF and other topics (see S2 & S3 Files) were discussed during the focus group discussions [ 22 ]. The questions (order and formulation) were analyzed and discussed several times by the researchers and moderator(s) of this study in online meetings.…”

Section: Methodsmentioning

confidence: 99%

Factors influencing the use of therapeutic footwear in persons with diabetes mellitus and loss of protective sensation: A focus group study

et al. 2023

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Background Persons with diabetes mellitus (DM) and loss of protective sensation (LOPS) due to peripheral neuropathy do not use their therapeutic footwear (TF) consistently. TF is essential to prevent foot ulceration. In order to improve compliance in using TF, influencing factors need to be identified and analyzed. Persons with a history of foot ulceration may find different factors important compared with persons without ulceration or persons who have never used TF. Therefore, the objective of this study was to determine factors perceived as important for the use of TF by different groups of persons with DM and LOPS. Method A qualitative study was performed using focus group discussions. Subjects (n = 24) were divided into 3 focus groups based on disease severity: ulcer history (HoU) versus no ulcer history (no-HoU) and experience with TF (TF) versus no experience (no-TF). For each group of 8 subjects (TF&HoU; TF&no-HoU; no-TF&no-HoU), an online focus group discussion was organized to identify the most important influencing factors. Transcribed data were coded with Atlas.ti. The analysis was performed following the framework approach. Results The factors comfort and fit and stability/balance were ranked in the top 3 of all groups. Usability was ranked in the top 3 of group-TF&noHoU and group-noTF&noHoU. Two other factors, reducing pain and preventing ulceration were ranked in the top 3 of group-TF&noHoU and group-TF&HoU, respectively. Conclusion Experience with TF and a HoU influence which factors are perceived as important for TF use. Knowledge of these factors during the development and prescription process of TF may lead to increased compliance. Although the main medical reason for TF prescription is ulcer prevention, only 1 group gave this factor a high ranking. Therefore, next to focusing on influencing factors, person-centered education on the importance of using TF to prevent ulcers is also required.

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A user-centered qualitative study on experiences with ankle-foot orthoses and suggestions for improved design

Cited by 21 publications

References 18 publications

Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: qualitative interview study of patient perspectives

Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: qualitative interview study of patient perspectives

Development and Initial Evaluation of a Soft Ankle Support for Children With Ankle Impairments

Factors influencing the use of therapeutic footwear in persons with diabetes mellitus and loss of protective sensation: A focus group study

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