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. 2022 Feb 25;5(1):37795.
doi: 10.33137/cpoj.v5i1.37795. eCollection 2022.

Experts' Perceived Patient Burden and Outcomes of Knee-ankle-foot-orthoses (Kafos) Vs. Microprocessor-stance-and-swing-phase-controlled-knee-ankle-foot Orthoses (Mp-sscos)

B Brüggenjürgen  1 , F Braatz  2 , B Greitemann  3 , H Drewitz  4 , A Ruetz  5 , M Schäfer  6 , W Seifert  7 , F Steinfeldt  8 , C Weichold  9 , D Yao  10 , C Stukenborg-Colsman  10
Affiliations

Experts' Perceived Patient Burden and Outcomes of Knee-ankle-foot-orthoses (Kafos) Vs. Microprocessor-stance-and-swing-phase-controlled-knee-ankle-foot Orthoses (Mp-sscos)

B Brüggenjürgen et al. Can Prosthet Orthot J. .

Abstract

Background: Patients with neuromuscular knee-instability assisted with orthotic devices experience problems including pain, falls, mobility issues and limited engagement in daily activities.

Objectives: The aim of this study was to analyse current real-life burden, needs and orthotic device outcomes in patients in need for advanced orthotic knee-ankle-foot-orthoses (KAFOs).

Methodology: An observer-based semi-structured telephone interview with orthotic care experts in Germany was applied. Interviews were transcribed and content-analysed. Quantitative questions were analysed descriptively.

Findings: Clinical experts from eight centres which delivered an average of 49.9 KAFOs per year and 13.3 microprocessor-stance-and-swing-phase-controlled-knee-ankle-foot orthoses (MP-SSCOs) since product availability participated. Reported underlying conditions comprised incomplete paraplegia (18%), peripheral nerve lesions (20%), poliomyelitis (41%), post-traumatic lesions (8%) and other disorders (13%). The leading observed patient burdens were "restriction of mobility" (n=6), followed by "emotional strain" (n=5) and "impaired gait pattern" (n=4). Corresponding results for potential patient benefits were seen in "improved quality-of-life" (n=8) as well as "improved gait pattern" (n=8) followed by "high reliability of the orthosis" (n=7). In total, experts reported falls occurring in 71.5% of patients at a combined annual frequency of 7.0 fall events per year when using KAFOs or stance control orthoses (SCOs). In contrast, falls were observed in only 7.2 % of MPSSCO users.

Conclusion: Advanced orthotic technology might contribute to better quality of life of patients, improved gait pattern and perceived reliability of orthosis. In terms of safety a substantial decrease in frequency of falls was observed when comparing KAFO and MP-SSCO users.

Keywords: Ankle Foot Orthoses; KAFO; Knee Instability; MP-SCCOs; Microprocessor Orthoses; Patient Burden; Poliomyelitis; Quality of Life; Survey.

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Conflict of interest statement

Bernd Brüggenjürgen, Frank Braatz, Bernhard Greitemann, Axel Ruetz, Friedemann Steinfeldt, Daiwei Yao, and Christina Stukenborg-Colsman received lecture fees; Heiko Drewitz is an employee of Otto Bock; Michael Schäfer, Wolfgang Seifert have collaborations with the sponsor. Claudia Weichold none to be declared.

Figures

Figure 1:
Figure 1:
Patient impairments and burden as perceived by experts
Figure 2:
Figure 2:
Expert-observed frequency of impairments (reported more than one time). Categories (always, often, sometimes, seldom, never) were transferred to 0-100-scale with 100 representing the highest frequency “always”.
Figure 3:
Figure 3:
Reported expert-perceived patient benefits.
Figure 4:
Figure 4:
Relevance of suggested patient assessment criteria.
Figure 5:
Figure 5:
Observed long-term consequences (primary axis: number of experts reporting, secondary axis: Transposed frequency of consequences in percent of time occurring - Categories (always, often, sometimes, seldom, never) were transferred to 0-100-scale with 100 representing the highest frequency “always”.)
See this image and copyright information in PMC

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