4.4 Article

Orthotic shorts for improving gait and walking in multiple sclerosis: a feasibility study

Journal

DISABILITY AND REHABILITATION
Volume 45, Issue 18, Pages 3000-3011

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/09638288.2022.2114018

Keywords

Orthotic shorts; dynamic elastomeric fabric orthoses; walking; multiple sclerosis; gait variability; acceptability

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This study explored the acceptability and potential efficacy of orthotic shorts in people with multiple sclerosis. The results showed that orthotic shorts were acceptable to most users and could improve walking, stability, and function in these patients. However, some users found them less acceptable due to restrictions in hip flexion or appearance.
Purpose To explore the acceptability and potential efficacy of orthotic shorts in people with multiple sclerosis. Materials and methods This mixed-methods, cross-over study utilised qualitative data to investigate acceptability, including perceived effectiveness. Quantitative data included wear times, self-selected walking speed, spatiotemporal gait parameters, and participant-perceived walking ability. Fifteen participants were assessed with and without two pairs of custom-made shorts: one designed as an orthotic and a second looser pair. Each were worn at home for two weeks. Semi-structured interviews were conducted at the first and final appointments. Quantitative data were analysed using Cohen's d; qualitative analysis used a thematic framework. A triangulation protocol integrated qualitative and quantitative data. Results Orthotic shorts were acceptable to most users who described improved control, stability, and function. Where shorts were less acceptable, this was due to restriction of hip flexion or appearance. Effect sizes were in the moderate category for participant-perceived walking ability and for those spatiotemporal gait parameters that reflect mediolateral stability. Small effect sizes were seen for walking speed and related spatiotemporal parameters, such as step length. Conclusion Orthotic shorts are acceptable and potentially efficacious for improving walking, stability, and function in people with multiple sclerosis. Further research and design development are warranted.

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