Experts' Perceived Patient Burden and Outcomes of Knee-ankle-foot-orthoses (Kafos) Vs. Microprocessor-stance-and-swing-phase-controlled-knee-ankle-foot Orthoses (Mp-sscos)

B Brüggenjürgen; F Braatz; B Greitemann; H Drewitz; A Ruetz; M Schäfer; W Seifert; F Steinfeldt; C Weichold; D Yao; C Stukenborg-Colsman

doi:10.33137/cpoj.v5i1.37795

Experts' Perceived Patient Burden and Outcomes of Knee-ankle-foot-orthoses (Kafos) Vs. Microprocessor-stance-and-swing-phase-controlled-knee-ankle-foot Orthoses (Mp-sscos)

Can Prosthet Orthot J. 2022 Feb 25;5(1):37795. doi: 10.33137/cpoj.v5i1.37795. eCollection 2022.

Authors

B Brüggenjürgen¹, F Braatz², B Greitemann³, H Drewitz⁴, A Ruetz⁵, M Schäfer⁶, W Seifert⁷, F Steinfeldt⁸, C Weichold⁹, D Yao¹⁰, C Stukenborg-Colsman¹⁰

Affiliations

¹ Institute for Health Services Research and Technical Orthopedics, Orthopedic Department - Medical School Hannover (MHH) at DIAKOVERE Annastift Hospital, Hannover, Germany.
² Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie Universitätsmedizin Göttingen, Georg-August-Universität, Göttingen, Germany.
³ RehaKlinikum Bad Rothenfelde, Klinik Münsterland, Bad Rothenfelde, Germany.
⁴ Abteilung Orthetik, Otto Bock HealthCare Deutschland GmbH, Göttingen, Germany.
⁵ Klinik für Konservative Orthopädie, Katholisches Klinikum Koblenz, Montabaur, Germany.
⁶ Orthopädie-Technik, Pohlig GmbH, Traunstein, Germany.
⁷ Technische Orthopädie, Seifert Technische Orthopädie GmbH, Bad Krozingen, Germany.
⁸ Fachklinik und Gesundheitszentrum, Johannesbad Raupennest GmbH & Co. KG, Altenberg, Germany.
⁹ Technische Orthopädie, Stiftung Orthopädische Universitätsklinikum, Heidelberg, Germany.
¹⁰ Foot Department and Technical Orthopedics, Orthopedic Department - Medical School Hannover (MHH) at DIAKOVERE Annastift Hospital, Hannover, Germany.

Abstract

Background: Patients with neuromuscular knee-instability assisted with orthotic devices experience problems including pain, falls, mobility issues and limited engagement in daily activities.

Objectives: The aim of this study was to analyse current real-life burden, needs and orthotic device outcomes in patients in need for advanced orthotic knee-ankle-foot-orthoses (KAFOs).

Methodology: An observer-based semi-structured telephone interview with orthotic care experts in Germany was applied. Interviews were transcribed and content-analysed. Quantitative questions were analysed descriptively.

Findings: Clinical experts from eight centres which delivered an average of 49.9 KAFOs per year and 13.3 microprocessor-stance-and-swing-phase-controlled-knee-ankle-foot orthoses (MP-SSCOs) since product availability participated. Reported underlying conditions comprised incomplete paraplegia (18%), peripheral nerve lesions (20%), poliomyelitis (41%), post-traumatic lesions (8%) and other disorders (13%). The leading observed patient burdens were "restriction of mobility" (n=6), followed by "emotional strain" (n=5) and "impaired gait pattern" (n=4). Corresponding results for potential patient benefits were seen in "improved quality-of-life" (n=8) as well as "improved gait pattern" (n=8) followed by "high reliability of the orthosis" (n=7). In total, experts reported falls occurring in 71.5% of patients at a combined annual frequency of 7.0 fall events per year when using KAFOs or stance control orthoses (SCOs). In contrast, falls were observed in only 7.2 % of MPSSCO users.

Conclusion: Advanced orthotic technology might contribute to better quality of life of patients, improved gait pattern and perceived reliability of orthosis. In terms of safety a substantial decrease in frequency of falls was observed when comparing KAFO and MP-SSCO users.

Keywords: Ankle Foot Orthoses; KAFO; Knee Instability; MP-SCCOs; Microprocessor Orthoses; Patient Burden; Poliomyelitis; Quality of Life; Survey.