An Ankle Foot Orthosis Implementation To Improve Mobility In Peripheral Artery Disease

Abstract

<h3>Research Objectives</h3> To explore the perceptions of wearing an ankle foot orthosis (AFO) in patients with peripheral artery disease (PAD). This follows a clinical trial of the effectiveness of an AFO in improving walking distances for patients with PAD-related claudication. <h3>Design</h3> A randomized crossover trial of standard of care and an AFO for three months. Semi-structured interviews were conducted 1.5 months into the AFO intervention to understand acceptability, demand, implementation, and practicality. Questionnaires were administered and claudication time recorded at baseline and after 3-month intervention. Six -month post intervention mixed methods assessments based on i-PARIHS framework were conducted. <h3>Setting</h3> Vascular surgery clinic and biomechanics research laboratory. <h3>Participants</h3> Claudication times and questionnaires were noted at baseline and 3 months for (n=22) participants. 7 subjects met the IRB post intervention criteria and participated in the study. <h3>Interventions</h3> A certified orthotist fit subjects with an AFO that was worn for three months. <h3>Main Outcome Measures</h3> Qualitative analysis of the semi-structured interviews and quantitative analysis of the surveys, Walking impairment questionnaire and Short-form 36 medical outcomes questionnaire, as well as claudication times assessed at baseline and 3 months. <h3>Results</h3> Key differences in responses were found. Patients withdrawing before 3 months had negative perceptions, comorbidities, and physical discomfort. Positive aspects of the AFO such as ease in standing and walking, as well as walking straighter and longer with less pain were reported by all participants Claudication times also showed improvement after 3 months. For surveys highest rating was seen in the complexity (4.6/5) and the cost dimension (4.3/5). The patients found the AFO and instructions easy to follow when starting the intervention. <h3>Conclusions</h3> The subset of preliminary data from the AFO intervention is beneficial towards assessing the implementation success and improvement in quality of life in patients who wore the AFO for three months. <h3>ACKNOWLEDGEMENTS</h3> This research was supported by NIH grants (RO1AG034995 and RO1HD090333), VA Merit grant (I01 RX003266) and UNO GRACA 2020-2021 grant. <h3>Author(s) Disclosures</h3> None to declare.