{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T08:02:45Z","timestamp":1789718565798,"version":"4.0.1"},"reference-count":38,"publisher":"BMJ","issue":"10","funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","award":["13\/30\/02"],"award-info":[{"award-number":["13\/30\/02"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,9,9]]},"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Adults with knee instability related to neuromuscular disorders or central nervous conditions often experience mobility problems and rely on orthoses to improve function and mobility. Patient views of device effectiveness and acceptability are underexplored. Our study aimed to elicit device users\u2019 perspectives regarding fitting, acceptability, effectiveness and use of orthoses, and identify important treatment outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative descriptive study using in-depth semistructured interviews. Interview transcriptions were coded and thematically analysed, using \u2018Framework\u2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and participants<\/jats:title>\n                    <jats:p>A purposive sample of 24 adult users of orthotic devices. Nineteen patients were recruited across three National Health Service sites, and five people through charities\/patient support groups in England. Half of the participants had been diagnosed with poliomyelitis, and the remainder with multiple sclerosis, Charcot-Marie-Tooth disease, spinal injury or spina bifida, and stroke. The median age of participants was 64.5 years (range 36\u201380 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients\u2019 medical condition impacted significantly on daily life. Participants relied on orthotic devices to enable engagement in daily activities. Patient goals for mobility were linked to individual circumstances. Desired treatment outcomes included reduction in pain, trips and falls, with improved balance and stability. Effectiveness, reliability, comfort and durability were the most valued features of orthoses and associated with reported use. Obtaining suitable footwear alongside orthotic devices was a significant concern. Time pressures during device fitting were viewed negatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Orthotic devices for knee instability play a crucial role in promoting, maintaining and enhancing physical and psychological health and well-being, enabling patients to work, engage in family life and enjoy social activities. Future research should consider how best to measure the impact of orthotic devices on patient quality of life and daily functioning outside the clinic setting, as well as device use and any adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      This qualitative study was retrospectively registered as Current Controlled Trials\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"ISRCTN65240228\">ISRCTN65240228<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-029313","type":"journal-article","created":{"date-parts":[[2019,10,18]],"date-time":"2019-10-18T09:18:04Z","timestamp":1571390284000},"page":"e029313","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: qualitative interview study of patient perspectives"],"prefix":"10.1136","volume":"9","author":[{"given":"Dorothy","family":"McCaughan","sequence":"first","affiliation":[{"name":"York Trials Unit, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7138-6295","authenticated-orcid":false,"given":"Alison","family":"Booth","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cath","family":"Jackson","sequence":"additional","affiliation":[{"name":"York Trials Unit, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Lalor","sequence":"additional","affiliation":[{"name":"Orthotics, Queen Mary\u2019s Hospital, St George\u2019s University Hospitals NHS Foundation Trust, London, UK"},{"name":"Orthotics\/Prosthetics, Royal Children\u2019s Hospital Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gita","family":"Ramdharry","sequence":"additional","affiliation":[{"name":"Faculty of Allied Health, Midwifery and Social Care, Kingston University\/St George's University of London, London, UK"},{"name":"Queen Square Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rory J","family":"O'Connor","sequence":"additional","affiliation":[{"name":"Academic Department of Rehabilitation Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Phillips","sequence":"additional","affiliation":[{"name":"Rehabilitation, Derby Hospitals\/ Nottingham University, Derby, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Bowers","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3751-7260","authenticated-orcid":false,"given":"Catriona","family":"McDaid","sequence":"additional","affiliation":[{"name":"York Trials Unit, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,10,17]]},"reference":[{"key":"2025121410583022000_9.10.e029313.1","doi-asserted-by":"publisher","DOI":"10.1002\/pri.531"},{"key":"2025121410583022000_9.10.e029313.2","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1177\/0309364615592696","article-title":"Neurological patients and their lower limb orthotics: an observational pilot study about acceptance and satisfaction","volume":"41","author":"Swinnen","year":"2017","journal-title":"Prosthet Orthot Int"},{"key":"2025121410583022000_9.10.e029313.3","first-page":"27","article-title":"Poor compliance with ankle-foot-orthoses in Charcot-Marie-Tooth disease","volume":"44","author":"Vinci","year":"2008","journal-title":"Eur J Phys Rehabil Med"},{"key":"2025121410583022000_9.10.e029313.4","first-page":"437","article-title":"Ankle-foot orthotic management in neuromuscular disorders: recommendations for future research","volume":"7","author":"Chisholm","year":"2012","journal-title":"Disabil Rehabil"},{"key":"2025121410583022000_9.10.e029313.5","doi-asserted-by":"crossref","first-page":"P187","DOI":"10.1097\/00008526-200606001-00007","article-title":"KAFOs for Ambulation: An Orthotist's Perspective","volume":"18","author":"Michael","year":"2006","journal-title":"JPO Journal of Prosthetics and Orthotics"},{"key":"2025121410583022000_9.10.e029313.6","unstructured":"Chavda A , Cheema K . 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