Foot and Ankle Patients Prefer a Hands-Free Single Crutch Compared to Standard Axillary Crutches

Abstract

Category: Ankle Introduction/Purpose: Following lower extremity surgery patients are often required to utilize assistive devices in order to perform activities of daily living. As technology and assistive devices continue to improve, providers are faced with selecting a device that is safe while providing high patient satisfaction and a quick return to actives. The purpose of the current study was to compare physical exertion and subject preference between a hands-free single crutch and standard axillary crutches in foot and ankle patients. Methods: A prospective, randomized crossover study was performed using 35 orthopedic foot and ankle patients from within one treatment facility. Each participant had demographic data and heart rate recorded. The patients were then randomized to an assistive device. All participants completed a 6-minute walk test (6MWT); immediately following each 6MWT heart rate, self-selected walking velocity (SSWV), perceived exertion using OMNI Rating of Perceived Exertion (OMNI-RPE) and perceived dyspnea using Modified Borg Dyspnea Scale was obtained. The patients then completed another 6MWT using the other assistive device and was asked the same questions. After completing both 6MWTs participants were asked which assistive device they would prefer to use. Results: A total of 35 patients were included with a median age of 32-year-old. The hands-free crutch was preferred by 86% of participants. Regression analysis was used to test if factors such as gender, height, weight, BMI predicted patient preference of iWalk vs. Crutch. None of these factors were found to be significant. Student t-tests and ANOVAs were performed separately for dyspnea, fatigue ratings, distance (meters) and heart rate between iWalk and crutch all were found to be significant (p<0.05, p=1.13e-11, p=2.29e-13, p=5.21e-05, respectively). The axillary crutch group had higher SSWV (0.8 vs 0.77m/s) but was not found to be significant. Neither group had any falls, however, 58% of axillary participants complained of axillary/hand pain while the hands-free group had 14% complain of proximal strap discomfort. Conclusion: Patients preferred the hands-free crutch while reporting lower perceived dyspnea and fatigue. The hands-free group demonstrated lower physiologic demand, which correlated with patient perception.