Assessing wear time and perceptions of wearing an ankle foot orthosis in patients with peripheral artery disease

Authors

Danae Dinkel, University of Nebraska at OmahaFollow
Mahdi Hassan, University of Nebraska at OmahaFollow
Holly DeSpiegelaere, Omaha and Western Iowa Veterans Affairs Medical CenterFollow
Jason Johanning, VA Nebraska-Western Iowa Healthcare System; University of Nebraska Medical Center
Iraklis Pipinos, Department of Surgery, Veterans Affairs Medical Center and University of Nebraska Medical Center, Omaha, NE USAFollow
Sara Myers, University of Nebraska at OmahaFollow

Author ORCID Identifier

Dinkel - https://orcid.org/0000-0002-0262-4429

Myers - https://orcid.org/0000-0002-2934-2624

Document Type

Article

Publication Date

4-30-2022

Abstract

Background

Peripheral artery disease (PAD) is a cardiovascular disease that affects walking ability. An ankle foot orthosis (AFO) may improve walking distances in those with PAD. Little research has explored if those with PAD wear a prescribed AFO and their perceptions of wearing the device.

Objective

To assess wear time of an AFO and explore perceptions of wearing the device in patients with PAD.

Design

Convergent mixed methods.

Setting

The study was conducted through a tertiary care medical center, and the research participants used the device in the community.

Participants

Thirty-six patients, all older adult males, were enrolled in this study. Fourteen patients completed the study and 11 supplied sufficient accelerometer data to include in the analysis.

Interventions

An AFO was worn for 3 months. An accelerometer was placed on the AFO for 7 days at the midpoint (1.5 months) and endpoint of the intervention (3 months) to assess wear time. Semi-structured interviews explored patients' perceptions of wearing the AFO.

Main Outcome Measure

The primary outcome measure was wear time measured objectively via accelerometer and subjectively via interview.

Results

Patients (n = 14) wore the AFO approximately 8 hours/day. Patients reported barriers such as challenges wearing the AFO during daily household activities (using stairs, being on uneven terrain), discomfort, clothing or footwear issues, and driving challenges. Positive effects of wearing the AFO were also reported, primarily the ability to walk further.

Conclusions

An AFO may be an acceptable therapeutic intervention to improve perceived walking performance in older adult males with PAD. Addressing participants' perceptions of the AFO and barriers to wear are essential to increasing the positive effect the device has on participants' ambulatory activity.

Comments

This is the pre-peer reviewed version of the following article: Assessing wear time and perceptions of wearing an ankle foot orthosis in patients with peripheral artery disease in PM&R on April 30, 2022, which has been accepted and published in final form at https://doi.org/10.1002/pmrj.12829

This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

Journal Title

PM&R

Recommended Citation

Dinkel, D., Hassan, M., Rech, J.P., DeSpiegelaere, H., Johanning, J., Pipinos, I., & Myers, S. (Accepted). Assessing wear time and perceptions of wearing an ankle foot orthosis in patients with peripheral artery disease. PM&R: Journal of Injury, Function, and Rehabilitation. https://doi.org/10.1002/pmrj.12829