Meaning of fabric orthoses to long-term users with multiple sclerosis: An interpretative phenomenological analysis.

Abstract

Fabric orthoses are elasticated garments designed to provide support to the musculoskeletal system. They may benefit people with multiple sclerosis; however, in this population, their acceptability is largely unexplored. This study aimed to explore the meaning that fabric orthoses hold for people with multiple sclerosis and factors influencing acceptability. This is a qualitative study using an interpretative phenomenological analysis to explore the meaning ascribed to lived experience. Four people with multiple sclerosis participated in face-to-face semi-structured interviews. Two used upper limb orthotic sleeves for involuntary movement control, one used orthotic shorts, and one used a soft ankle brace. Three participants had fabric orthoses they no longer used. Themes were validated by peer review. Two themes were identified. "Giving back control" describes how perceived physical benefits, such as decreased involuntary movement and improved stability, led to important benefits in autonomy and self-image. Orthoses were not worn longer-term where self-image was not improved. "Learning to live with an orthosis" captures the way in which participants learnt from experience over months or years how to maximize effectiveness and overcome disadvantages. Acceptability was determined specific to the contexts in which the orthoses were used, with the social appropriateness of appearance and the demands of tasks being important considerations. Fabric orthoses can be acceptable to people with multiple sclerosis. Professionals should be mindful of the active learning process that users engage in as they learn about the pros and cons of orthotic use. Further research into effectiveness is needed.