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Observational Study
. 2018 Dec 22;19(1):453.
doi: 10.1186/s12891-018-2366-2.

Influence of age and level of activity on the applicability of a walker orthosis - a prospective study in different cohorts of healthy volunteers

Alena Sint  1 , Sebastian Felix Baumbach  2 , Wolfgang Böcker  2 , Christian Kammerlander  2 , Karl-Georg Kanz  3 , Mareen Braunstein  2 , Hans Polzer  4
Affiliations
Observational Study

Influence of age and level of activity on the applicability of a walker orthosis - a prospective study in different cohorts of healthy volunteers

Alena Sint et al. BMC Musculoskelet Disord. .

Abstract

Background: Walker orthosis are frequently prescribed as they are removable to allow wound control, body care and physiotherapy and are adaptable to the soft tissue conditions. The prerequisite for successful treatment with any walker orthosis is a correct use by the patient. Therefore, the aim of this study was to investigate patients' handling of a commonly used walker.

Methods: Prospective observational study analyzing the applicability of a walker orthosis in different cohorts with varying age and level of activity. Volunteers were recruited from a mountain-biking-team (Sport), a cardiovascular-health-sports-group (Cardio) and a retirement home (Senior). The correct application was assessed following initial training (t0) and one week later (t1). Outcome parameters were an Application Score, strap tightness, vertical heel lift-off and subjective judgement of correct application.

Results: Thirty-three volunteers, 11 Sports group (31 ± 7a), 12 Cardio group (59 ± 11a), 10 Senior group, (82 ± 5a) were enrolled. No differences for any parameter could be observed between t0 and t1. Age showed a moderate correlation for all outcome parameters and the cohort influenced all variables. The Senior group presented significant inferior results to the Sport- and Cardio group for the Application Score (p = 0.002-p < 0.001) and strap tightness (p < 0.001). Heel lift-off was significantly inferior in the Cardio- and Senior- compared to the Sport group (p = 0.003-p < 0.001). 14% in the Sport-, 4% in the Cardio- and 83% in the Senior group achieved less than 9 points in the Application Score - which was considered insufficient. However, out of these 90% believed the application to be correct.

Conclusions: The elderly cohort living in a retirement home demonstrated an impaired handling of the walker orthosis. Further, participants were incapable to self-assess the correct handling. These aspects should be respected when initiating treatment with a walker orthosis.

Trial registration: Retrospectively registered on the 16th of February 2018: # DRKS00013728 on DRKS.

Keywords: Ankle immobilisation; Elderly; Level of activity; Orthosis; Patient safety.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the institutional ethical review board of the University of Munich, Ludwigs-Maximilians-University (782–16). All participants signed written consent to participate in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Schematic illustration of the VACOPed®. 1. Lower shell; 2. Durable sole; 3. Vacuum cushion in fabric liner; 4. Upper shell; 5. Bulb pump; 6. Adjustable belt straps; 7. Adjustable joint
Fig. 2
Fig. 2
Schematic illustration of the Application score. 1. Pulling the valve of the vacuum cushion to allow air to enter; 2. Fluffing the vacuum cushion; 3. Placement of the foot in the vacuum cushion and adjustment of the vacuum cushion in the lower shell; 4. Pushing the heel into the vacuum cushion; 5. Placement of the upper shell over the front of the vacuum cushion; 6. Locking the straps in correct sequence (starting with the inner straps 1 and 2 and completing with the outer straps 3 and 4); 7. Making the vacuum cushion rigid using the bulb pump; 8. Fastening all four straps. The number of points assigned to each task is depicted in the lower row
Fig. 3
Fig. 3
Schematic illustration of the measurement for strap tightness
Fig. 4
Fig. 4
Boxplots illustration subgroup analysis of each variable per cohort. A: Application Score; B: Strap tightness pooled; C: Heel lift-off; 1: t0; 2: t1
See this image and copyright information in PMC

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