Prospective clinical evaluation of a novel anatomic cuff for forearm crutches in patients with osteoarthritis

Background: The use of forearm crutches has been associated with pain and neuropraxia along the ulnar bone. Whilst anatomic grips have improved comfort of crutch walking, to date anatomic forearm cuffs have not been clinically evaluated. The aim of this clinical pilot study was to determine if the use of forearm crutches with anatomic cuffs reduces pain and increases comfort and function in long-term users of forearm crutches during a 4week period. Method: Prospective study in ten patients suffering from end-stage osteoarthritis of the lower extremity. All participants were long-term users of conventional forearm crutches. Participants used forearm crutches with an anatomically shaped cuff for 4-weeks. General health was assessed using the SF-36, and the crutches were evaluated using a newly developed questionnaire focusing on symptoms along the forearm. Results: Pain and paresthesia along the forearms decreased by 3.3 points (95% confidence interval difference (CI): [-5.0; -1.6], p =.004) and 3.5 points (95% CI: [-5.1; -1.9], p =.002), respectively, after using the crutches with the new anatomic cuff for 4 weeks. Comfort and sense of security of crutch use increased by 3.0 points (95% CI: [ 1.3; 4.7], p =.007) and 2.4 points (95% CI: [ 0.7; 4.1], p =.024). Cross-correlation analysis revealed correlations among items in the same item category and no correlations between items of different item categories of the new questionnaires. Conclusion: An anatomically shaped cuff increases comfort of forearm crutches. Further research should confirm long-term clinical improvement. Trial registration: This study was registered retrospectively in ISRCTN (TRN: ISRCTN 11135150) on 14/02/2017.