Orthotic shorts for improving gait and walking in multiple sclerosis: a feasibility study

Abstract

Purpose To explore the acceptability and potential efficacy of orthotic shorts in people with multiple sclerosis. Materials and methods This mixed-methods, cross-over study utilised qualitative data to investigate acceptability, including perceived effectiveness. Quantitative data included wear times, self-selected walking speed, spatiotemporal gait parameters, and participant-perceived walking ability. Fifteen participants were assessed with and without two pairs of custom-made shorts: one designed as an orthotic and a second looser pair. Each were worn at home for two weeks. Semi-structured interviews were conducted at the first and final appointments. Quantitative data were analysed using Cohen’s d; qualitative analysis used a thematic framework. A triangulation protocol integrated qualitative and quantitative data. Results Orthotic shorts were acceptable to most users who described improved control, stability, and function. Where shorts were less acceptable, this was due to restriction of hip flexion or appearance. Effect sizes were in the moderate category for participant-perceived walking ability and for those spatiotemporal gait parameters that reflect mediolateral stability. Small effect sizes were seen for walking speed and related spatiotemporal parameters, such as step length. Conclusion Orthotic shorts are acceptable and potentially efficacious for improving walking, stability, and function in people with multiple sclerosis. Further research and design development are warranted. Implications for rehabilitation Orthotic shorts are a type of fabric orthosis that have not been previously researched but might assist pelvic stability. Orthotic shorts appear to be acceptable to those people with multiple sclerosis who perceive themselves to be unstable around the trunk and hips. Orthotic shorts might improve gait stability and self-perceived walking ability.