Use and usability of custom-made knee-ankle-foot orthoses in polio survivors with knee instability: A cross-sectional survey


  • Bart Raijmakers Department of Rehabilitation, Amsterdam UMC, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
  • Roelofine A. Berendsen-de Gooijer
  • Hilde E. Ploeger
  • Fieke S. Koopman
  • Frans Nollet
  • Merel-Anne Brehm



poliomyelitis, leg muscle weakness, knee-ankle-foot orthoses, usability, physical mobility, rehabilitation


Objective: To investigate the use of custom-made knee-ankle-foot-orthoses in daily life and differences in usability factors of knee-ankle-foot-orthoses between users and discontinued users.

Design: Cross-sectional survey study.

Subjects: A total of 163 polio survivors provided with a knee-ankle-foot-orthosis at an outpatient clinic of a university hospital.

Methods: Use and usability of knee-ankle-foot-
orthoses in daily life were assessed with a postal questionnaire. Usability factors were formulated using the International Organization for Standardization (ISO) 9241-11 standard.

Results: A total of 106 respondents (65%) returned the questionnaire. Of these, 98 were eligible for analysis. Seventy-four respondents (76%) reported using their knee-ankle-foot-orthosis. Compared with discontinued users (24%), users experienced more limitations when walking without an orthosis (p = 0.001), were more often experienced with wearing a previous orthosis (p < 0.001) and were more often prescribed with a locked rather than a stance-control knee-ankle-foot-orthosis (p = 0.015). Furthermore, users reported better effectiveness of their knee-ankle-foot-orthosis (p < 0.001), more satisfaction with goals of use and knee-ankle-foot-orthosis-related aspects (p < 0.001).

Conclusion: The majority of polio survivors used their custom-made knee-ankle-foot-orthoses in daily life. Factors related to continued use, such as walking ability without orthosis, expectations of the orthosis, previous orthosis experience and type of knee-ankle-foot-orthosis provided, should be considered and discussed when prescribing a knee-ankle-foot-orthosis in polio survivors. 


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How to Cite

Raijmakers, B., Berendsen-de Gooijer, R. A., Ploeger, H. E., Koopman, F. S., Nollet, F., & Brehm, M.-A. (2021). Use and usability of custom-made knee-ankle-foot orthoses in polio survivors with knee instability: A cross-sectional survey. Journal of Rehabilitation Medicine, 53.



Original Report