Assessing Wear Time And Perceptions Of Wearing An Ankle Foot Orthosis In Patients With Peripheral Artery Disease
Sara Myers, PhD1, Danae Dinkel, PhD1, Mahdi Hassan, MS1, Holly DeSpiegelaere2, Jason Johanning, MD3, Iraklis Pipinos, MD3, John Rech, MS1.
1University of Nebraska at Omaha, Omaha, NE, USA, 2VA Nebraska-Western Iowa Healthcare System, Omaha, NE, USA, 3University of Nebraska Medical Center, Omaha, NE, USA.
OBJECTIVES: Peripheral artery disease (PAD) affects patients’ walking performance. An ankle foot orthosis (AFO) is a cost-effective assistive device that may improve patients’ walking distances. Little research has explored if and when patients wear their prescribed AFO. This study objectively assessed wear time and the associated perceptions of wearing an AFO in patients with PAD. METHODS: This convergent mixed methods study objectively assessed wear time and perceptions of wear time of an AFO among adult males with PAD (n=14). AFO wear time was captured with an accelerometer was placed on the AFO for 7 days at mid-point (1.5 months) and post-intervention (3 months). To assess perceptions of wear time, semi-structured interviews were conducted at these same time points. Wear time was calculated using the Actilife software’s weartime validation algorithm and compared via independent t-tests between mid-point and post intervention. Perceptions of wear time were qualitatively analyzed using a directed content analysis approach. RESULTS: Patients wore the AFO around 8 hours/day. Wear time did not change significantly when comparing total days, week days or weekend days from mid-point to post intervention. A majority of patients felt they wore the AFO a majority of the time. Patients experienced barriers which may have limited their wear time such as challenges wearing the AFO during daily household activities (going up and down stairs, being on uneven terrain). Other barriers reported were discomfort, clothing or footwear issues, and driving challenges. Almost all patients reported positive impacts of wearing the AFO, primarily the ability to walk further. CONCLUSIONS: An AFO may be an acceptable therapeutic intervention to improve walking distance in patients with peripheral artery disease. Addressing patients’ perceptions of the AFO and barriers to wear are essential to increasing the positive impact the device has on patients’ ambulatory activity
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