Use of the ICF to investigate impairment, activity limitation and participation restriction in people using ankle-foot orthoses to manage mobility disabilities

Research output: Contribution to journalArticle

Abstract

This study investigated differences in impairment, activity limitation, participation restrictions and psychological distress between participants using ankle-foot orthoses (AFOs) as recommended, participants who did not use AFOs as recommended and participants who did not know recommendations for use.  Adults (n = 157) fitted with an AFO by an NHS Orthotic Service in Scotland completed a postal questionnaire that measured impairment, activity limitations participation restrictions and psychological distress using scales from the RAND 36-Item Health Survey 1.0 and the Hospital Anxiety and Depression Scale (HADS).  41% of participants used their AFOs as recommended, 32% did not use their AFOs as recommended and 27% did not know the recommendations for use. Participants using AFOs as recommended reported lower levels of impairment and activity limitations, indicated by higher energy levels (p = 0.005), higher physical functioning (p = 0.005), lower role-limitations due to emotional problems (p = 0.001) and lower levels of anxiety (p = 0.003) compared to people not using AFOs as recommended.  Health professionals need to ensure whether patients understand the recommendations for use of their AFO. Additionally, the results of the study support the value of evaluating patients' psychological well-being to gain a better understanding of AFO use. Implications for Rehabilitation Participants who reported using AFOs as recommended had significantly lower levels of impairment, activity limitations and anxiety compared to those who did not use their AFO as recommended. In this study, 27% of participants did not know recommendations for use of AFOs. Health professionals should give consideration as to how information, regarding wearing instructions and use of AFOs, is provided to people who are prescribed AFOs. Psychological outcomes in orthotics are rarely assessed. However, this study demonstrates there is a value in measuring psychological outcomes in orthotic management.

LanguageEnglish
Pages605-612
Number of pages8
JournalDisability and Rehabilitation
Volume38
Issue number6
Early online date18 Jun 2015
DOIs
Publication statusPublished - 16 Mar 2016

Fingerprint

Foot Orthoses
Ankle
Psychology
Anxiety
Health
Scotland
Health Surveys

Keywords

  • activity limitation
  • ankle-foot orthoses
  • ICF
  • impairment
  • participation restriction
  • use

Cite this

@article{1a3bf49d056d4fd281bea2c373598be1,
title = "Use of the ICF to investigate impairment, activity limitation and participation restriction in people using ankle-foot orthoses to manage mobility disabilities",
abstract = "This study investigated differences in impairment, activity limitation, participation restrictions and psychological distress between participants using ankle-foot orthoses (AFOs) as recommended, participants who did not use AFOs as recommended and participants who did not know recommendations for use.  Adults (n = 157) fitted with an AFO by an NHS Orthotic Service in Scotland completed a postal questionnaire that measured impairment, activity limitations participation restrictions and psychological distress using scales from the RAND 36-Item Health Survey 1.0 and the Hospital Anxiety and Depression Scale (HADS).  41{\%} of participants used their AFOs as recommended, 32{\%} did not use their AFOs as recommended and 27{\%} did not know the recommendations for use. Participants using AFOs as recommended reported lower levels of impairment and activity limitations, indicated by higher energy levels (p = 0.005), higher physical functioning (p = 0.005), lower role-limitations due to emotional problems (p = 0.001) and lower levels of anxiety (p = 0.003) compared to people not using AFOs as recommended.  Health professionals need to ensure whether patients understand the recommendations for use of their AFO. Additionally, the results of the study support the value of evaluating patients' psychological well-being to gain a better understanding of AFO use. Implications for Rehabilitation Participants who reported using AFOs as recommended had significantly lower levels of impairment, activity limitations and anxiety compared to those who did not use their AFO as recommended. In this study, 27{\%} of participants did not know recommendations for use of AFOs. Health professionals should give consideration as to how information, regarding wearing instructions and use of AFOs, is provided to people who are prescribed AFOs. Psychological outcomes in orthotics are rarely assessed. However, this study demonstrates there is a value in measuring psychological outcomes in orthotic management.",
keywords = "activity limitation, ankle-foot orthoses, ICF, impairment, participation restriction, use",
author = "Christine McMonagle and Susan Rasmussen and Elliott, {Mark A.} and Diane Dixon",
note = "This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation on 18th of June 2015, available online: http://www.tandfonline.com/0.3109/09638288.2015.1055374.",
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AU - Rasmussen, Susan

AU - Elliott, Mark A.

AU - Dixon, Diane

N1 - This is an Accepted Manuscript of an article published by Taylor & Francis in Disability and Rehabilitation on 18th of June 2015, available online: http://www.tandfonline.com/0.3109/09638288.2015.1055374.

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N2 - This study investigated differences in impairment, activity limitation, participation restrictions and psychological distress between participants using ankle-foot orthoses (AFOs) as recommended, participants who did not use AFOs as recommended and participants who did not know recommendations for use.  Adults (n = 157) fitted with an AFO by an NHS Orthotic Service in Scotland completed a postal questionnaire that measured impairment, activity limitations participation restrictions and psychological distress using scales from the RAND 36-Item Health Survey 1.0 and the Hospital Anxiety and Depression Scale (HADS).  41% of participants used their AFOs as recommended, 32% did not use their AFOs as recommended and 27% did not know the recommendations for use. Participants using AFOs as recommended reported lower levels of impairment and activity limitations, indicated by higher energy levels (p = 0.005), higher physical functioning (p = 0.005), lower role-limitations due to emotional problems (p = 0.001) and lower levels of anxiety (p = 0.003) compared to people not using AFOs as recommended.  Health professionals need to ensure whether patients understand the recommendations for use of their AFO. Additionally, the results of the study support the value of evaluating patients' psychological well-being to gain a better understanding of AFO use. Implications for Rehabilitation Participants who reported using AFOs as recommended had significantly lower levels of impairment, activity limitations and anxiety compared to those who did not use their AFO as recommended. In this study, 27% of participants did not know recommendations for use of AFOs. Health professionals should give consideration as to how information, regarding wearing instructions and use of AFOs, is provided to people who are prescribed AFOs. Psychological outcomes in orthotics are rarely assessed. However, this study demonstrates there is a value in measuring psychological outcomes in orthotic management.

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