The Continuity of Orthosis Use by Paraplegics which Had Been Prescribed During In-Patient Rehabilitation

Objective: Orthoses, such as hip-knee-ankle-foot orthosis, metal or plastic ankle-foot orthosis, and posterior shell; and aids, such as crutches, Lofstrand forearm orthosis, walkers, canes, and wheelchairs, providing locomotion are frequently used in the rehabilitation of spinal cord injury. This study aimed to assess orthosis usage habits and to determine the problems related to orthosis in spinal cord injury patients after discharge from inpatient rehabilitation. Material and Methods: Seventy-one patients were reviewed initially from hospital records. Forty-six patients [ 34 males (74%), 12 females (26%)] were available for telephone interviews to complete a questionnaire. Results: The mean age was 35 +/- 12.9 years; the mean duration from injury was 43 +/- 27 months. The mean orthosis usage index (duration of orthosis use/the duration of prescription of orthosis) was 0.7 +/- 0.3. Among the 41 patients who were given orthoses, 30 patients (73%) used their orthosis, and 11 patients (27%) did not use their orthosis. The ratio of terminating orthosis use was significantly higher in patients with incomplete spinal cord injury (82%) when compared to patients with complete injury (18%) (p=0.038). The ratio of modifying the orthosis (53%) was significantly higher in the orthosis user group than in the non-user group (9%) (p=0.014). In the logistic regression analysis, the presence of sacral sparing was found to be influential toward the direction of decreasing orthosis use (p=0.040). Most of the reasons for terminating orthosis use were modifiable factors, such as spasticity, tightness or wearing out the orthosis, and psychological disturbances. Conclusion: Our results suggest that there is a greater possibility for terminating orthosis use in patients with sacral sparing. Modification of the orthosis is a necessity for regular orthosis users. The wheelchair is the main form of locomotion and is regularly used by spinal cord injury patients.