Bashir Ayisha Z, Dinkel Danae M, Bapat Ganesh M, Despiegelaere Holly, Hassan Mahdi, Johanning Jason M, Pipinos Iraklis I, Myers Sara A
Department of Biomechanics, University of Nebraska at Omaha, Omaha, Nebraska.
Department of Health and Kinesiology, University of Nebraska at Omaha, Omaha, Nebraska.
Arch Rehabil Res Clin Transl. 2021 Jan 5;3(1):100092. doi: 10.1016/j.arrct.2020.100092. eCollection 2021 Mar.
To explore the perceptions of wearing an ankle-foot orthosis (AFO) in patients with peripheral artery disease (PAD) who did and did not adopt the AFO intervention. This follows a clinical trial of the effectiveness of an AFO in improving walking distances for patients with PAD-related claudication.
A randomized crossover trial of standard of care and an AFO for 3 months. Semistructured interviews were conducted 1.5 months into the AFO intervention to understand acceptability, demand, implementation, and practicality. Data were analyzed using a summative content analysis approach.
Vascular surgery clinic and biomechanics research laboratory.
Patients (N=15; male, 100%; age, 71.9±.6.7y; body mass index [calculated as weight in kilograms divided by height in meters squared], 29.0±.5.5; ankle brachial index: AFO intervention withdrawal, 0.543; AFO intervention completion, 0.740) with claudication completed the study, and 6 withdrew prior to intervention completion.
A certified orthotist fit participants with an AFO that was worn for 3 months.
Qualitative analysis of the semistructured interviews.
Key differences were reported between AFO intervention completion and AFO intervention withdrawal. Six of 14 of AFO intervention completion participants described their initial reactions to the AFO as negative vs 3 of 6 AFO intervention withdrawal participants. Only 5 of 15 AFO intervention completion participants reported minimal use of the AFO compared with 5 of 6 AFO intervention withdrawal participants. The AFO intervention withdrawal group reported higher levels of physical discomfort with the use of the AFO (4/6 vs 7/15) and preexisting health issues becoming a barrier to the use of the AFO (3/6 vs 5/15). Positive aspects reported included ease in standing and walking for AFO intervention withdrawal (4/6) and AFO intervention completion groups (13/15) as well as walking straighter and longer with less pain for AFO intervention withdrawal (3/6) and AFO intervention completion groups (9/15).
Patients withdrawing prior to completion of AFO intervention tended to have more negative perceptions, more comorbidities, and more physical discomfort than those completing the intervention. Both groups reported positive aspects of the AFO. Implementation studies are needed to address barriers to AFO adoption.
探讨外周动脉疾病（PAD）患者中采用和未采用踝足矫形器（AFO）干预者对佩戴AFO的看法。此前进行了一项关于AFO改善PAD相关间歇性跛行患者步行距离有效性的临床试验。
一项为期3个月的标准护理与AFO随机交叉试验。在AFO干预1.5个月后进行半结构化访谈，以了解可接受性、需求、实施情况和实用性。采用总结性内容分析方法对数据进行分析。
血管外科诊所和生物力学研究实验室。
患有间歇性跛行的患者（N = 15；男性，100%；年龄，71.9±6.7岁；体重指数[按千克体重除以身高米的平方计算]，29.0±5.5；踝臂指数：AFO干预退出者为0.543，AFO干预完成者为0.740）完成了研究，6人在干预完成前退出。
由认证的矫形师为参与者佩戴AFO，佩戴3个月。
对半结构化访谈进行定性分析。
报告了AFO干预完成者与AFO干预退出者之间的关键差异。AFO干预完成的14名参与者中有6人将他们对AFO的初始反应描述为负面，而AFO干预退出的6名参与者中有3人持此看法。与AFO干预退出的6名参与者中有5人相比，AFO干预完成的15名参与者中只有5人报告很少使用AFO。AFO干预退出组报告使用AFO时身体不适程度更高（4/6比7/15），且既往健康问题成为使用AFO的障碍（3/6比5/15）。报告的积极方面包括AFO干预退出组（4/6）和AFO干预完成组（13/15）站立和行走更轻松，以及AFO干预退出组（3/6）和AFO干预完成组（9/15）行走更直、更远且疼痛减轻。
在AFO干预完成前退出的患者往往比完成干预的患者有更多负面看法、更多合并症和更多身体不适。两组都报告了AFO的积极方面。需要开展实施研究以解决采用AFO的障碍。
