Predicting adherence to ankle-foot orthoses in people with stroke : an application of the theory of planned behaviour

McMonagle, Christine and Rasmussen, Susan and Rooney, Robbie and Elliott, Mark (2024) Predicting adherence to ankle-foot orthoses in people with stroke : an application of the theory of planned behaviour. Prosthetics and Orthotics International. ISSN 0309-3646 (In Press)

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Abstract

Background: Ankle-foot Orthoses (AFOs) are often prescribed for people with stroke to address the motor impairment. However not all patients adhere to using their AFOs as prescribed. Predictors of AFO-adherence are likely to constitute useful targets for interventions that aim to promote this behaviour. Objective: Identify the predictors of AFO-adherence in people with stroke using an established theoretical framework, namely the Theory of Planned Behaviour (TPB; Ajzen, 1991). Study Design: Prospective survey design. Method: N=49 people who had been prescribed an AFO following a stroke completed a TPB questionnaire. One month later, they completed another questionnaire that measured adherence to AFOs as prescribed by an orthotic practitioner. Predictors of intention and AFO-adherence behaviour were identified using regression analyses. Results Adherence to AFOs was 63%. The TPB accounted for 61% of the variance in intentions and 43% of the variance in AFO-adherence behaviour. Attitude and perceived behavioural control were predictors of intention, and intention the sole predictor of behaviour. Conclusion The TPB is a useful model for explaining adherence to AFOs in people stroke. Interventions could be designed to increase intentions to use an AFO as prescribed by promoting positive attitudes towards AFO adherence.

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