Patient Preferences and Functional Outcomes of Forearm Crutches vs Hands-Free Single Crutches After Foot and Ankle Surgery: A Randomized Crossover Trial
Background: Assistive devices facilitate daily activities and recovery, and are essential for nonweightbearing ambulation after orthopaedic foot or ankle surgery. This study aimed to compare the usability of forearm crutches (FCs) and hands-free single crutches (HFSCs) during the early postoperative...
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| Format: | Article |
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SAGE Publishing
2025-08-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/24730114251363494 |
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| author | Vincent Georg Werner MD Christian Plaass MD Sarah Ettinger MD Leif Claassen MD Anna Altemeier-Sasse MD Lars-Rene Tuecking MD Kiriakos Daniilidis MD Daiwei Yao MD |
| author_facet | Vincent Georg Werner MD Christian Plaass MD Sarah Ettinger MD Leif Claassen MD Anna Altemeier-Sasse MD Lars-Rene Tuecking MD Kiriakos Daniilidis MD Daiwei Yao MD |
| author_sort | Vincent Georg Werner MD |
| collection | DOAJ |
| description | Background: Assistive devices facilitate daily activities and recovery, and are essential for nonweightbearing ambulation after orthopaedic foot or ankle surgery. This study aimed to compare the usability of forearm crutches (FCs) and hands-free single crutches (HFSCs) during the early postoperative recovery phase in terms of their effects on mobility, speed, safety, range, endurance, personal preference, and quality of life. Methods: This prospective randomized crossover study included 35 participants. Assessments included the 36-Item Short-Form Survey, Short Musculoskeletal Function Assessment Questionnaire, and European Foot and Ankle Society Score administered preoperatively and at 2 follow-up examinations. Patients were assigned to either device (FC or HFSC) for the first 3 weeks after surgery. The primary outcome was number of stumble events (SEs) during standardized mobility tests. For secondary outcomes (including mobility, speed, and range), patients completed clinical tests such as the 6-minute walk test, stair-climbing test, 10-m walk test, and indoor and outdoor parkour activities. Following the clinical tests, the patients provided qualitative feedback, including personal preference and overall device usage. After switching the devices, the tests were repeated at 6 weeks postoperatively. Results: Although FCs performed better in most mobility tests, patients favored HFSCs because of enhanced comfort and lower perceived exertion. Despite the physical advantages of FCs, patients tended to prefer HFSCs owing to their ergonomic benefits. The quality of life and physical function scores for both devices declined after surgery, reflecting a typical postoperative recovery phase. Younger and male patients generally performed better with HFSCs, whereas female, older, and overweight patients faced more challenges. Conclusion: FCs outperform HFSCs with respect to mobility, but patients prefer HFSCs due to comfort and reduced exertion although the clinical significance of these perceived differences remains uncertain. This underscores the need for personalized device recommendations to improve postoperative outcomes. This study highlights the complexity of device selection based on individual patient needs and preferences. Level of Evidence: Level II, prospective, randomized comparative study. |
| format | Article |
| id | doaj-art-9e81a25f25b649dabb2b2509f3ae2b5a |
| institution | Kabale University |
| issn | 2473-0114 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj-art-9e81a25f25b649dabb2b2509f3ae2b5a2025-08-23T09:03:19ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142025-08-011010.1177/24730114251363494Patient Preferences and Functional Outcomes of Forearm Crutches vs Hands-Free Single Crutches After Foot and Ankle Surgery: A Randomized Crossover TrialVincent Georg Werner MD0Christian Plaass MD1Sarah Ettinger MD2Leif Claassen MD3Anna Altemeier-Sasse MD4Lars-Rene Tuecking MD5Kiriakos Daniilidis MD6Daiwei Yao MD7Department of Orthopedic and Trauma Surgery, DIAKOVERE Friederikenstift, Hannover, GermanyOrthopedic Clinic, Hannover Medical School in DIAKOVERE Annastift, Hannover, GermanyUniversity Hospital for Orthopedics, Pius Hospital Oldenburg, GermanyOrthoprofis, Hannover, GermanyUniversity Hospital for Orthopedics, Pius Hospital Oldenburg, GermanyOrthopedic Clinic, Hannover Medical School in DIAKOVERE Annastift, Hannover, GermanyOTC Regensburg, GermanyFachärzte Rhein-Main, Seligenstadt, GermanyBackground: Assistive devices facilitate daily activities and recovery, and are essential for nonweightbearing ambulation after orthopaedic foot or ankle surgery. This study aimed to compare the usability of forearm crutches (FCs) and hands-free single crutches (HFSCs) during the early postoperative recovery phase in terms of their effects on mobility, speed, safety, range, endurance, personal preference, and quality of life. Methods: This prospective randomized crossover study included 35 participants. Assessments included the 36-Item Short-Form Survey, Short Musculoskeletal Function Assessment Questionnaire, and European Foot and Ankle Society Score administered preoperatively and at 2 follow-up examinations. Patients were assigned to either device (FC or HFSC) for the first 3 weeks after surgery. The primary outcome was number of stumble events (SEs) during standardized mobility tests. For secondary outcomes (including mobility, speed, and range), patients completed clinical tests such as the 6-minute walk test, stair-climbing test, 10-m walk test, and indoor and outdoor parkour activities. Following the clinical tests, the patients provided qualitative feedback, including personal preference and overall device usage. After switching the devices, the tests were repeated at 6 weeks postoperatively. Results: Although FCs performed better in most mobility tests, patients favored HFSCs because of enhanced comfort and lower perceived exertion. Despite the physical advantages of FCs, patients tended to prefer HFSCs owing to their ergonomic benefits. The quality of life and physical function scores for both devices declined after surgery, reflecting a typical postoperative recovery phase. Younger and male patients generally performed better with HFSCs, whereas female, older, and overweight patients faced more challenges. Conclusion: FCs outperform HFSCs with respect to mobility, but patients prefer HFSCs due to comfort and reduced exertion although the clinical significance of these perceived differences remains uncertain. This underscores the need for personalized device recommendations to improve postoperative outcomes. This study highlights the complexity of device selection based on individual patient needs and preferences. Level of Evidence: Level II, prospective, randomized comparative study.https://doi.org/10.1177/24730114251363494 |
| spellingShingle | Vincent Georg Werner MD Christian Plaass MD Sarah Ettinger MD Leif Claassen MD Anna Altemeier-Sasse MD Lars-Rene Tuecking MD Kiriakos Daniilidis MD Daiwei Yao MD Patient Preferences and Functional Outcomes of Forearm Crutches vs Hands-Free Single Crutches After Foot and Ankle Surgery: A Randomized Crossover Trial Foot & Ankle Orthopaedics |
| title | Patient Preferences and Functional Outcomes of Forearm Crutches vs Hands-Free Single Crutches After Foot and Ankle Surgery: A Randomized Crossover Trial |
| title_full | Patient Preferences and Functional Outcomes of Forearm Crutches vs Hands-Free Single Crutches After Foot and Ankle Surgery: A Randomized Crossover Trial |
| title_fullStr | Patient Preferences and Functional Outcomes of Forearm Crutches vs Hands-Free Single Crutches After Foot and Ankle Surgery: A Randomized Crossover Trial |
| title_full_unstemmed | Patient Preferences and Functional Outcomes of Forearm Crutches vs Hands-Free Single Crutches After Foot and Ankle Surgery: A Randomized Crossover Trial |
| title_short | Patient Preferences and Functional Outcomes of Forearm Crutches vs Hands-Free Single Crutches After Foot and Ankle Surgery: A Randomized Crossover Trial |
| title_sort | patient preferences and functional outcomes of forearm crutches vs hands free single crutches after foot and ankle surgery a randomized crossover trial |
| url | https://doi.org/10.1177/24730114251363494 |
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