Factors Influencing Orthotist Decision Making When Providing Carbon Fiber Ankle Foot Orthoses
Jason M. Wilken, PT, PhD
Carbon fiber ankle foot orthoses (CFOs) are used to address a variety of conditions, from limb trauma to dorsiflexor weakness. However, limited information is available to inform which CFO design is most appropriate for a given patient, or to identify which patient factors influence outcomes. Forty-six certified orthotists were surveyed about their clinical evaluation and decision making processes. Many clinicians consider the same factors when providing CFOs, rely on subjective measures during patient assessments, and have varying opinions regarding which patient factors are most likely to result in successful outcomes with CFO use. The results of this study can be used help guide future study design and educational content.
Sensitivity to Change of Patient-reported and Performance Measures for Custom AFO Users
Allen W. Heinemann, PhD
Patient-reported outcome measures (PROMs) are not used widely to evaluate the benefits of lower-limb orthoses, in part, because there is no consensus on what to measure and little psychometric evidence for PROMs in this population orthoses users. This study builds on our efforts to assess patient and clinician perspectives on quality-of-care topics that are important to measure for custom ankle-foot orthosis (AFOs) users (Heinemann et al., 2020); identify quality-of-care instruments to assess care quality for individuals using custom AFOs (Fatone et al., 2021), and assess orthotists' and physical therapists' perspectives on quality-of-care indicators (Heinemann et al., 2021). Aims of this report are to assess sensitivity to change of instruments measuring quality-of-care indicators valued by patients and clinicians.
Improved Promis Global Health for Individuals Seeking Orthotic Intervention
Emily J. Hurst, MPO, CPO
The aim of this study was to characterize PROMIS global health and identify factors associated with PROMIS global health outcomes for those seeking an AFO.
Orthotist Use of Outcome Measures in Clinic
Eric Weber, LCPO, FAAOP(D)
Outcome measures in clinical practice can be used to track health status and process and inform decision making, but little is known about which measures are used and when and the barriers to implementation. Fifty-four certified orthotists were surveyed about their knowledge, use, and barriers to use of outcome measures. Participants recognized the benefits of outcome measures, but only half consistently use patient-reported or performance-based measures. Practitioners identified available time, space, and knowledge of which measures to use as factors preventing outcome measure use.