Eddison N, Healy A, Buchanan D, Chockalingam N
Centre for Biomechanics and Rehabilitation Technologies, School of Life Sciences and Education, Staffordshire University, Leek Road, Stoke-on-Trent ST4 2DF, United Kingdom; The Royal Wolverhampton NHS Trust, New Cross Hospital, Wednesfield Road, Wolverhampton WV10 0QP, United Kingdom.
Centre for Biomechanics and Rehabilitation Technologies, School of Life Sciences and Education, Staffordshire University, Leek Road, Stoke-on-Trent ST4 2DF, United Kingdom.
Foot (Edinb). 2022 Dec;53:101924. doi: 10.1016/j.foot.2022.101924. Epub 2022 Mar 17.
To validate a new classification system for bespoke thermoplastic ankle foot orthoses (AFOs).
Inter- and intra-observer reliability study. A classification system based on the design and function of AFOs was created. Sixty-three independent observers classified thirty-six photographs of different AFOs, according to the proposed classification system via an online questionnaire. Approximately two weeks later, the same AFOs were classified again by fifty-three of the same participants. All participants were health care professionals, researchers, or technicians with experience in referring for, prescribing, fitting, reviewing, researching or manufacturing AFOs.
The mean inter- and intra-observer agreement Fleiss' kappa was 0.932 and 0.944, respectively. 98.3% of participants reported that the classification system was very easy or moderately easy to use, with 85.7% reporting they would use the classification system. 90.5% of participants reported that the proposed AFO classification system was clear, with 84% stating it was useful.
The proposed classification system for bespoke thermoplastic AFOs, has an excellent inter- and intra-observer agreement. It will reduce the ambiguity of the description of the type of AFOs used in clinical practice and research. Furthermore, it makes reproducible comparisons between groups possible, which are essential for future evaluations of evidence-based orthotic care.
验证一种定制热塑性踝足矫形器（AFO）的新分类系统。
观察者间和观察者内可靠性研究。创建了一种基于AFO设计和功能的分类系统。63名独立观察者通过在线问卷，根据所提出的分类系统对36张不同AFO的照片进行分类。大约两周后，53名相同的参与者再次对相同的AFO进行分类。所有参与者均为医疗保健专业人员、研究人员或在转介、开处方、适配、复查、研究或制造AFO方面有经验的技术人员。
观察者间和观察者内一致性的平均Fleiss' kappa分别为0.932和0.944。98.3%的参与者报告称该分类系统使用起来非常容易或比较容易，85.7%的参与者表示他们会使用该分类系统。90.5%的参与者报告称所提出的AFO分类系统清晰，84%的参与者表示其有用。
所提出的定制热塑性AFO分类系统在观察者间和观察者内具有出色的一致性。它将减少临床实践和研究中使用的AFO类型描述的模糊性。此外，它使组间可重复比较成为可能，这对于未来基于证据的矫形护理评估至关重要。
