Perspectives on ankle-foot technology for improving gait performance of children with Cerebral Palsy in daily-life: requirements, needs and wishes.


Journal

Journal of neuroengineering and rehabilitation
ISSN: 1743-0003
Titre abrégé: J Neuroeng Rehabil
Pays: England
ID NLM: 101232233

Informations de publication

Date de publication:
12 04 2023
Historique:
received: 18 05 2022
accepted: 30 03 2023
medline: 14 4 2023
entrez: 12 4 2023
pubmed: 13 4 2023
Statut: epublish

Résumé

Ankle-foot orthoses (AFOs) are extensively used as a primary management method to assist ambulation of children with Cerebral Palsy (CP). However, there are certain barriers that hinder their prescription as well as their use as a mobility device in all kinds of daily-life activities. This exploratory research attempts to further understand the existing limitations of current AFOs to promote a better personalization of new design solutions. Stakeholders' (professionals in CP and end-users with CP) perspectives on AFO technology were collected by two online surveys. Respondents evaluated the limitations of current assistive solutions and assessment methods, provided their expectations for a new AFO design, and analyzed the importance of different design features and metrics to enrich the gait performance of these patients in daily-life. Quantitative responses were rated and compared with respect to their perceived importance. Qualitative responses were classified into themes by using content analysis. 130 survey responses from ten countries were analyzed, 94 from professionals and 36 from end-users with CP. The most highly rated design features by both stakeholder groups were the comfort and the ease of putting on and taking off the assistive device. In general, professionals preferred new features to enrich the independence of the patient by improving gait at functional levels. End-users also considered their social acceptance and participation. Health care professionals reported a lack of confidence concerning decision-making about AFO prescription. To some degree, this may be due to the reported inconsistent understanding of the type of assistance required for each pathological gait. Thus, they indicated that more information about patients' day-to-day walking performance would be beneficial to assess patients' capabilities. This study emphasizes the importance of developing new approaches to assess and treat CP gait in daily-life situations. The stakeholders' needs and criteria reported here may serve as insights for the design of future assistive devices and for the follow-up monitoring of these patients.

Sections du résumé

BACKGROUND
Ankle-foot orthoses (AFOs) are extensively used as a primary management method to assist ambulation of children with Cerebral Palsy (CP). However, there are certain barriers that hinder their prescription as well as their use as a mobility device in all kinds of daily-life activities. This exploratory research attempts to further understand the existing limitations of current AFOs to promote a better personalization of new design solutions.
METHODS
Stakeholders' (professionals in CP and end-users with CP) perspectives on AFO technology were collected by two online surveys. Respondents evaluated the limitations of current assistive solutions and assessment methods, provided their expectations for a new AFO design, and analyzed the importance of different design features and metrics to enrich the gait performance of these patients in daily-life. Quantitative responses were rated and compared with respect to their perceived importance. Qualitative responses were classified into themes by using content analysis.
RESULTS
130 survey responses from ten countries were analyzed, 94 from professionals and 36 from end-users with CP. The most highly rated design features by both stakeholder groups were the comfort and the ease of putting on and taking off the assistive device. In general, professionals preferred new features to enrich the independence of the patient by improving gait at functional levels. End-users also considered their social acceptance and participation. Health care professionals reported a lack of confidence concerning decision-making about AFO prescription. To some degree, this may be due to the reported inconsistent understanding of the type of assistance required for each pathological gait. Thus, they indicated that more information about patients' day-to-day walking performance would be beneficial to assess patients' capabilities.
CONCLUSION
This study emphasizes the importance of developing new approaches to assess and treat CP gait in daily-life situations. The stakeholders' needs and criteria reported here may serve as insights for the design of future assistive devices and for the follow-up monitoring of these patients.

Identifiants

pubmed: 37046284
doi: 10.1186/s12984-023-01162-3
pii: 10.1186/s12984-023-01162-3
pmc: PMC10099972
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

44

Informations de copyright

© 2023. The Author(s).

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Auteurs

Cristina Bayón (C)

Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands. c.bayoncalderon@utwente.nl.
Centro de Automática y Robótica, Universidad Politécnica de Madrid, Consejo Superior de Investigaciones Científicas, Madrid, Spain. c.bayoncalderon@utwente.nl.

Marleen van Hoorn (MV)

Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands.

Antonio Barrientos (A)

Centro de Automática y Robótica, Universidad Politécnica de Madrid, Consejo Superior de Investigaciones Científicas, Madrid, Spain.

Eduardo Rocon (E)

Centro de Automática y Robótica, Universidad Politécnica de Madrid, Consejo Superior de Investigaciones Científicas, Madrid, Spain.

Joyce P Trost (JP)

Gillette Children's, Saint Paul, MN, USA.

Edwin H F van Asseldonk (EHFV)

Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands.

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Classifications MeSH