User experience of passive hip flexion device in people with multiple sclerosis: Exploring improvements and overcoming barriers

Abstract

Background:. Multiple sclerosis (MS) is a chronic disease that primarily affects young adults and causes disability by impairing the central nervous system. Gait impairments are common in people with MS (pwMS), and lower limb orthoses are often used to improve stability and mobility. However, compliance with orthotic devices can vary among individuals due to issues related to the appropriate prescription and lack of acceptability. Objective:. In this observational, cross-sectional study, we aimed to explore the experience of wearing a passive hip flexion device in a cohort of pwMS. Methods:. We included men and women >18 years old affected by MS (Expanded Disability Status Scale >4) who have been using a passive hip flexion device (ExoBand, Moveo srl) since 2020 for at least 15 days. The participants completed a phone survey that collected demographic, anthropometric, and clinical data, their perceptions of the device’s impact using the Psychosocial Impact of Assistive Devices (PIADS) questionnaire, and a qualitative part with an open-ended question. Results:. A total of 41 patients completed the survey. The participants experienced improvements in all 3 areas of the PIADS questionnaire since using the ExoBand (P<0.001). The area of competence showed the highest improvement, particularly in terms of efficiency and usefulness. The majority of participants (85.4%) perceived an improvement from using the device, reporting better quality of movement and increased walking distance. Only a small percentage (26.8%) did not perceive any benefits, mainly due to discomfort and personal factors. Conclusions:. This study highlighted the satisfaction among pwMS with the use of the ExoBand device and emphasized the importance of addressing individual needs during the orthotic prescription process. This study represents the first exploration of the perspective and perception of using a passive hip flexion device in pwMS. Our results support the need to assess user experience and the psychosocial impact of these devices on people’s lives to better understand the barriers and reasons behind their underutilization. Further research with a larger and heterogeneous population is recommended to gather more comprehensive data.