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成人下肢矫形器使用者的活动体验:一项焦点小组研究。

Mobility experiences of adult lower limb orthosis users: a focus group study.

机构信息

Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.

Gillette Children's Specialty Healthcare, St. Paul, MN, USA.

出版信息

Disabil Rehabil. 2022 Dec;44(25):7904-7915. doi: 10.1080/09638288.2021.2002437. Epub 2021 Nov 22.

Abstract

PURPOSE

People with lower limb impairments are often prescribed orthoses to preserve or enhance their mobility. Exploration of mobility experiences common among orthosis users may provide insights into how orthoses, and other mobility aids, are utilized and regarded. The objective of this study was to broadly explore how lower limb orthosis users describe their mobility.

MATERIALS AND METHODS

Four focus groups were held online with participants who lived in the U.S. or Canada. Participants had at least six months of experience using an ankle-foot- and/or a knee-ankle-foot-orthosis for one or both legs. All discussions were transcribed and coded. Thematic analysis was used to identify cross-cutting themes.

RESULTS

Participants included 29 orthosis users with a variety of health conditions. Inter-related themes, including personal factors, situational contexts, and assistance were identified as elements that influenced participants' mobility. Participants described a process of modifying their mobility through the use and non-use of one or more mobility aids.

CONCLUSIONS

The current study findings may assist clinicians in developing strategies to optimize orthosis users' mobility in different situations. Experiences described by participants in this study may also help researchers identify aspects of mobility most pertinent to orthosis users and inform the development of new outcome measures.Implications for RehabilitationPeople who use lower-limb orthoses share common mobility experiences, despite differences in health diagnoses.Orthosis users often have opportunities to modify their mobility by choosing to use or not use their brace(s) and/or handheld mobility aids.When providing mobility aid interventions, clinicians should consider how each patient's individual characteristics, including physical characteristics (e.g., the health condition and how it presents, pain, fatigue) and psychosocial characteristics (e.g., fear and confidence, self-motivation, emotional responses), can affect mobility.Clinicians may be able to help patients optimize their mobility by asking about environmental obstacles they regularly encounter and recommending strategies for utilization of mobility aids, including simultaneous use of multiple aids, use of one aid, or choosing not to use any aids, depending on the activity and situation.Clinicians should inquire about all mobility aids available to a patient at home and in the community, including fixed objects, and consider how new mobility aid interventions might affect the patient's mobility when used alone and in combination with other forms of assistance.

摘要

目的

下肢功能障碍者常被开具矫形器以维持或增强其活动能力。探索矫形器使用者的常见活动能力体验可以深入了解矫形器和其他活动能力辅助器具的使用和看法。本研究的目的是广泛探讨下肢矫形器使用者如何描述其活动能力。

材料与方法

在美国或加拿大居住的参与者参加了 4 次在线焦点小组。参与者至少有 6 个月的单侧或双侧踝足矫形器或膝踝足矫形器的使用经验。所有讨论均进行了转录和编码。使用主题分析法识别贯穿各主题的内容。

结果

参与者包括 29 名患有各种健康状况的矫形器使用者。确定了相互关联的主题,包括个人因素、情境背景和辅助因素,这些因素影响参与者的活动能力。参与者描述了通过使用和不使用一种或多种活动能力辅助器具来调整其活动能力的过程。

结论

本研究结果可能有助于临床医生制定在不同情况下优化矫形器使用者活动能力的策略。本研究参与者描述的经验也可能有助于研究人员确定与矫形器使用者最相关的活动能力方面,并为新的结局测量指标的制定提供信息。

康复意义

使用下肢矫形器的人尽管健康诊断不同,但他们具有共同的活动能力体验。矫形器使用者常常有机会通过选择使用或不使用其支具和/或手持式活动能力辅助器具来调整其活动能力。在提供活动能力辅助器具干预时,临床医生应考虑每位患者的个体特征,包括身体特征(例如,健康状况及其表现、疼痛、疲劳)和心理社会特征(例如,恐惧和信心、自我激励、情绪反应),这些因素如何影响活动能力。通过询问患者经常遇到的环境障碍并建议根据活动和情况选择使用活动能力辅助器具的策略,包括同时使用多种辅助器具、使用一种辅助器具或选择不使用任何辅助器具,临床医生可以帮助患者优化其活动能力。临床医生应询问患者在家中和社区中可获得的所有活动能力辅助器具,包括固定物体,并考虑新的活动能力辅助器具干预措施单独使用和与其他形式的辅助相结合时如何影响患者的活动能力。

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