Safety and walking ability of KAFO users with the C-Brace® Orthotronic Mobility System, a new microprocessor stance and swing control orthosis.
Eva Pröbsting, Andreas Kannenberg, Britta Zacharias
PMID 27151648WHAT IT FOUND
Thirteen knee orthosis users reported a microprocessor knee orthosis, given with fitting and training, was easier and safer than previous orthoses for many daily activities, especially mobility, stairs, ramps and uneven ground.
Dressing and hygiene did not improve.
Key findings
01Compared with all previous orthoses, patients reported significant improvement in the Orthosis Evaluation Questionnaire total score (p = .03) and in ambulation (p = .001), paretic limb health (p = .04), sounds (p = .02), and well-being (p = .01) after fitting and training with the C-Brace.
02Compared with all previous orthoses, patients rated family and social life (p = .01) and mobility and transportation (p = .002) significantly easier with the C-Brace after fitting and training, and sports (p = .02) and other activities (p = .03) also improved significantly; personal hygiene and dressing did not differ.
03Across 585 comparative responses after fitting and training with the C-Brace, 54% of difficulty ratings favored the C-Brace, 39% showed no difference, and 7% favored previous orthoses; 59% of safety ratings favored the C-Brace, 37% showed no difference, and 4% favored previous orthoses.
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 study included only 13 patients, selected as a convenience sample, so it cannot show how most KAFO users would respond. The design was a pre-post survey with no randomization and no crossover control of device order. Patients were fitted and trained to use the C-Brace and received regular fittings, so the study cannot separate the effect of the orthosis from fitting and training. The outcomes were self-reported and the Orthosis Evaluation Questionnaire and Activities of Daily Living Questionnaire were not validated for leg orthosis users. The authors were employees of the manufacturer of the C-Brace, and the company supported the article writing.
Declared interests
All authors are employees of Otto Bock HealthCare, the manufacturer of the C-Brace. Otto Bock HealthCare allowed the authors to work on the article during regular working hours and use company office equipment.
The easy way to misread this
Do not read the significant questionnaire scores as proof that the C-Brace alone objectively improves walking safety or function. Patients were fitted and trained to use it, and received regular fittings, so the study cannot separate the device effect from fitting and training. It was also a small uncontrolled survey of patients' own ratings, and the outcomes were not validated for orthosis users.