Aspects determining adherence to wrist-hand orthoses in patients with peripheral neuropathies

Abstract

BACKGROUND: People with peripheral neuropathies suffer significant sensorimotor impairment. Prescribed treatment includes the use of orthosis. However, a common obstacle to treatment efficacy is patient adherence. Given the limited information available, gathering evidence on adherence to orthotic treatment is essential. OBJECTIVE: This study aims to identify aspects that influence adherence to orthotic treatment in patients with peripheral neuropathies. METHODS: We applied a survey including items from the assistive device evaluation section of Quest 2.0 and self-developed questions to assess the importance and satisfaction of wrist-hand orthosis users. We used the principles of the Kano model to understand the nature of issues influencing adherence and prioritize opportunities for product improvement. RESULTS: User satisfaction with the ease of adjustment, weight, comfort, effectiveness, durability, dimensions, and appearance of orthoses influences treatment adherence. CONCLUSIONS: We found differences in estimating the importance of orthosis aspects from direct consultation and estimation from the satisfaction-adherence correlation. Satisfaction is an indirect measure of importance and an adequate predictor of adherence. The application of Kano’s model allows a more precise identification of the influence of orthosis attributes on adherence. This method describes relationships between aspects that are not discernible in linear models.