title: Use of orthopedic shoes in patients with degenerative disorders of the foot.
abstract: OBJECTIVE
  To study the actual use of orthopedic shoes by patients with degenerative foot disorders and to identify factors associated with use and nonuse, based on the parameters of the International Organization for Standardization definition of usability: effectiveness, efficiency, satisfaction, and context of use.
  
  
  METHODS
  Multicenter, prospective cohort study.
  
  
  METHODS
  Outpatient clinics of 7 rehabilitation centers in the Netherlands.
  
  
  METHODS
  One hundred consecutive patients with degenerative foot disorders.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Usability was assessed by means of the Questionnaire for Usability Evaluation of orthopedic shoes.
  
  
  RESULTS
  Seventy of 93 patients with degenerative foot disorders wore their orthopedic shoes for more than 3 days a week after 3 months of follow-up. Factors significantly associated with the actual use of orthopedic shoes were (1) increase in stance duration (effectiveness odds ratio [OR]=2.14; 95% confidence interval [CI], 1.19-3.85), (2) decrease in skin abnormalities (effectiveness OR=1.35; 95% CI, 1.02-1.8]), (3) problems experienced with putting on and taking off orthopedic shoes (efficiency OR=.46; 95% CI, .26-.82), and (4) cosmetic appearance of orthopedic shoes (satisfaction OR=1.54; 95% CI, 1.1-2.15). The overall fit of the multiple logistic regression model ( R 2 ) was 56.3%.
  
  
  CONCLUSIONS
  By adding efficiency and satisfaction factors and not focusing only on the effectiveness factors, the amount of explained variance increases, and it becomes possible to evaluate and design products for people with special needs more comprehensively.
authors.affiliation: Rossingh Research and Development, Enschede, The Netherlands. m.jannink@rrd.nl
authors.forename: Michiel J
authors.initials: MJ
authors.lastname: Jannink
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Ijzerman
authors.forename: Karin
authors.initials: K
authors.lastname: Groothuis-Oudshoorn
authors.forename: Roy E
authors.initials: RE
authors.lastname: Stewart
authors.forename: Johan W
authors.initials: JW
authors.lastname: Groothoff
authors.forename: Gustaaf J
authors.initials: GJ
authors.lastname: Lankhorst
mesh_terms: D000368:Aged; D004867:Equipment Design; D005260:Female; D005534:Foot Diseases / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D017060:Patient Satisfaction; D011446:Prospective Studies; D012775:Shoes