Wearing Time for Lower-Limb Orthoses in Users with Pathological Gait Due to Neurological Disorder—Influences of Orthotic Concepts

Abstract

ABSTRACT Introduction Lower-limb orthoses are usually part of conservative therapy in patients with pathological gait due to neurological disorders. A modular design, defined as a detachable combination of different orthotic designs, offers the possibility to adapt orthosis functionality to individual needs. Currently, however, knowledge about the actual impact of modularity on wearing times is limited. The aim of the present study was therefore to examine the wearing time of modular and nonmodular orthoses to determine whether there are differences between the different orthotic concepts of the lower limb on weekdays and weekends and whether modularity affects wearing time. Material and Methods In this prospective clinical study, 53 patients with neurological gait disorder were included. All wore modular or nonmodular orthoses in one of these three groups: dynamic ankle-foot orthoses (DAFOs), ankle-foot orthoses (AFOs), and knee-ankle-foot orthoses (KAFOs). Wearing time was recorded by temperature sensors for 3 months. Data analysis included both descriptive and further parametric statistical testing (t-test for dependent and independent samples) as well as Pearson correlations. A univariate analysis of variance was used when comparing multiple groups. Results Participants wore DAFOs and AFOs, but not KAFOs, significantly longer on weekdays. Wearing time correlated significantly between weekdays and weekends for all groups. There is no significant difference in the mean daily wearing time between the groups. Modularity influenced the wearing time only for the DAFO/AFO combination. Conclusion Orthotic design and anatomic height affect the average daily wearing time. A change in wearing behavior between weekdays and weekends and influences by modularity can be found solely in DAFOs and AFOs.