Predicting adherence to ankle-foot orthoses in people with stroke: An application of the Theory of Planned Behavior.
Christine McMonagle, Susan Rasmussen, Robbie Rooney and 1 others
PMID 39240045WHAT IT FOUND
Stroke survivors who felt confident using their ankle-foot orthosis and held positive attitudes were significantly more likely to wear it as recommended.
Social pressure from others did not predict adherence. Clinicians should focus on building patient confidence and ensuring a positive initial fitting experience.
Key findings
01Intention was the sole significant predictor of actual adherence behavior, with a one-unit increase in intention associated with a 3.07-factor increase in the odds of adhering.
02Attitude and perceived behavioral control were significant independent predictors of intention to adhere, whereas subjective norms were not.
03The Theory of Planned Behavior model accounted for 61% of the variance in intentions and 43% of the variance in adherence behavior.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample size was small (n = 41), which may limit the generalizability of the findings. Adherence was measured via self-report, which may be less accurate than objective monitoring devices. The study was conducted in a single geographical area in Scotland, so results may not apply to other populations or healthcare systems. Other factors known to influence adherence, such as socioeconomic status and device comfort, were not included in the model.
Declared interests
The authors disclosed no potential conflicts of interest. The research received financial support from the Orthotics Education and Training Trust and the Center for Excellence in Rehabilitation at the University of Strathclyde.
The easy way to misread this
Do not assume that involving family or friends in encouragement will improve adherence. The study found that subjective norms (social pressure) did not significantly predict intention to use the AFO, whereas personal attitude and confidence did.