Orlando Julie M, Li Bai, Bodt Barry, Lobo Michele A
Department of Physical Therapy and Biomechanics & Movement Science Program, University of Delaware, Newark, DE.
Biostatistics Core Facility, College of Health Sciences, University of Delaware, Newark, DE.
Arch Phys Med Rehabil. 2023 Apr;104(4):645-655. doi: 10.1016/j.apmr.2022.10.010. Epub 2022 Nov 15.
To systematically review perceptions from adults, children, and caregivers in scientific and open sources to determine how well lower extremity orthotic devices (LEODs) meet users' functional, expressive, aesthetic, and accessibility (FEA2) needs.
Scientific source searches were conducted in the National Library of Medicine (PubMed/MEDLINE) and Web of Science; open source searches were conducted in Google Search Engine in April 2020.
Inclusion criteria were reporting of users' perceptions about a LEOD, experimental or observational study design, including qualitative studies, and full text in English. Studies were excluded if the device only provided compression or perception data could not be extracted. One hundred seventy three scientific sources of 3440 screened were included (total of 1108 perceptions); 36 open sources of 150 screened were included (total of 508 perceptions).
Users' perceptions were independently coded by 2 trained, reliable coders.
Across both source types, there were more perceptions about functional needs, and perceptions were more likely to be positive related to functional than expressive, aesthetic, or accessibility needs. Perceptions about expression, aesthetics, and accessibility were more frequently reported and more negative in open vs scientific sources. Users' perceptions varied depending on users' diagnosis and device type.
There is significant room for improvement in how LEODs meet users' FEA2 needs, even in the area of function, which is often the primary focus when designing rehabilitation devices. Satisfaction with LEODs may be improved by addressing users' unmet needs. Individuals often choose not to use prescribed LEODs even when LEODs improve their function. This systematic review identifies needs for LEODs that are most important to users and highlights how well existing LEODs address those needs. Attention to these needs in the design, prescription, and implementation of LEODs may increase device utilization.
系统回顾科学文献和公开资料中成人、儿童及照料者的看法，以确定下肢矫形器（LEOD）在多大程度上满足使用者的功能、表达、美学及可及性（FEA2）需求。
在国立医学图书馆（PubMed/MEDLINE）和科学网进行科学文献检索；2020年4月在谷歌搜索引擎进行公开资料检索。
纳入标准为报告使用者对LEOD的看法、实验性或观察性研究设计（包括定性研究）以及英文全文。若设备仅提供压迫作用或无法提取看法数据，则排除该研究。在筛选的3440篇科学文献中，纳入173篇（共1108条看法）；在筛选的150篇公开资料中，纳入36篇（共508条看法）。
由2名训练有素且可靠的编码员独立对使用者的看法进行编码。
在两种资料类型中，关于功能需求的看法更多，且与表达、美学或可及性需求相比，与功能相关的看法更可能呈积极态度。与科学文献相比，公开资料中关于表达、美学和可及性的看法报告得更频繁且更负面。使用者的看法因使用者的诊断和设备类型而异。
即使在功能领域（这通常是设计康复设备时的主要关注点），LEOD在满足使用者FEA2需求方面仍有很大改进空间。通过满足使用者未满足的需求，对LEOD的满意度可能会提高。即使LEOD能改善功能，个体也常常选择不使用医生开具的LEOD。本系统评价确定了对使用者最重要的LEOD需求，并突出了现有LEOD满足这些需求的程度。在LEOD的设计、处方和使用过程中关注这些需求可能会提高设备的利用率。
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