Influence of spacer fabric knee brace hole design on user-perceived comfort using AHP and PROMETHEE

Achieving an optimal balance between user-perceived support and overall comfort remains a key challenge in knee brace design. This study applied a multicriteria decision-making approach, integrating the analytic hierarchy process (AHP) and PROMETHEE (preference ranking organization method for enrichment evaluation), to evaluate three spacer-fabric-based brace designs with different aperture shapes: no hole, circular hole, and keyhole. All evaluation criteria were defined from the perspective of subjective user comfort, including sensations of support, breathability, heat, skin irritation, movement restriction, and joint feedback. AHP results showed that participants, after being sensitized to the definitions, prioritized support and stability (35%) and joint feedback (30%), indicating a desire for perceived functional benefit during use. PROMETHEE rankings revealed that the keyhole design achieved the highest overall preference score, offering the best balance between perceived support and comfort. The no hole design ranked second as it was particularly valued for its perceived support, while the circular hole design ranked lowest due to weaker user perception across most criteria.