Identification and analysis of knee-ankle-foot orthosis design requirements based on a feedback survey of orthosis users in India.

PURPOSE: The world is advancing towards a technological revolution in various fields, yet the assistive devices available for people with disability, especially in developing countries, are in the most primitive stage. For many years, lower limb orthotics has been a neglected area of research and there is an urgent need to address the problems faced by lower limb orthosis users to enable them to lead an independent life. This work is a first step in this direction and aims to identify and analyse the needs of knee-ankle-foot orthosis (KAFO) users in India.

METHOD: A structured feedback survey of 29 KAFO users was conducted at three rehabilitation centres located in South India. A feedback questionnaire and a novel outcome measure tool (trigger cards) were used as means to assess user satisfaction about their existing KAFOs. The results of the survey were analysed to obtain quantitative and qualitative outcomes.

RESULTS: The survey identifies various biomechanical and functional issues associated with lower limb orthosis design. The results of the survey imply that there is an urgent need to solve issues, especially related to locked orthotic knee joint design. Additionally, it sheds light on the lifestyle and socio-economic issues of KAFO users that are likely prevalent in many other low- and middle-income countries.

CONCLUSIONS: The outcomes of this survey can motivate and guide researchers to design improved orthotic solutions to meet the needs of lower limb orthosis users all over the world. Implications for Rehabilitation  • This is a first of its kind survey that brings forth the needs of lower limb orthosis users in India, and is an important step towards rehabilitation and empowerment of people with lower limb disability.  • The pilot survey helps to identify critical areas for design improvements in a knee-ankle-foot orthosis.  • The outcomes of this survey can help researchers to design functionally improved assistive devices that better meet the needs of users than currently available technology in developing countries such as India.