IMPLEMENTIATION OF AN ANKLE FOOT ORTHOSIS TO IMPROVE MOBILITY IN PERIPHERAL ARTERY DISEASE PATIENTS

An ankle- foot orthosis (AFO) can contribute to push-off during walking by storing energy from heel strike in the rigid strut and subsequently returning force during push-off. Through the substitution paradigm, the AFO decreases muscle and blood flow demand by substituting for the ankle plantar flexor torque and power. Peripheral artery disease (PAD), a manifestation of systemic atherosclerosis, blocks the arteries supplying blood to the legs and causes muscle pain and weakness, which leads to difficulty in walking. Wearing an AFO immediately increases the distance patients with PAD can walk. However, subjects almost immediately decide whether to adopt or not adopt the AFO. Our goal is to assess early AFO intervention withdrawal (wAFO) and AFO intervention completion (cAFO). Participants (n=21) were recruited and consented to wear an AFO for three months. The subjects were assessed for early AFO intervention withdrawal (n=6) and completion (n=15). Semi-structured interviews were conducted, and data were analyzed using a summative content analysis approach. Only six of fourteen of cAFO subjects described their initial reactions to the AFO as negative versus three of six wAFO subjects. The wAFO group reported higher levels of physical discomfort with the use of the AFO (4/6 vs 7/15) and pre-existing health issues as a barrier to the use of the AFO (3/6 vs 5/15). Patients withdrawing prior to completion of the AFO intervention tended to have increased negative perceptions, comorbidities, and physical discomfort. Both groups reported positive aspects of the AFO such as ease in standing and walking