Society for Prosthetics and Orthotics (original) (raw)
Related papers
Prosthetics and Orthotics International, 2014
Background: Spinal cord injury patients walk with a flexed trunk when using reciprocating gait orthoses. Reduction of trunk flexion during ambulation may produce an improvement in gait parameters for reciprocating gait orthosis users. Objectives: To investigate the effect on kinematics and temporal–spatial parameters when spinal cord injury patients ambulate with an advanced reciprocating gait orthosis while wearing a thoracolumbosacral orthosis to provide trunk extension. Study design: Comparative study between before and after use o thoracolumbosacral orthosis with the advanced reciprocating gait orthoses. Methods: Four patients with spinal cord injury were fitted with an advanced reciprocating gait orthosis and also wore a thoracolumbosacral orthosis. Patients walked along a flat walkway either with or without the thoracolumbosacral orthosis at their self-selected walking speed. Temporal–spatial parameters and lower limb kinematics were analyzed. Results: Mean walking speed, step...
Spinal Cord, 2015
The aim of this study was to evaluate the influence of walking with an isocentric reciprocating gait orthosis (IRGO) by spinal cord injury (SCI) patients on walking speed, distance walked and energy consumption whilst participating in a 12-week gait retraining program. Methods: Six people with motor complete SCI (mean age 29 years, weight 63 kg and height 160 cm with injury levels ranging from T8 to T12) participated in this study. Gait evaluation was performed at baseline and after 4, 8 and 12 weeks. Walking speed and heart rate were measured to calculate the resulting physiological cost index (PCI). Results: Reductions in energy consumption were observed after 4, 8 and 12 weeks compared with baseline but were not significant. However, walking distance increased significantly (P = 0.010, P = 0.003 and P = 0.005, respectively) and also did so during the 8-12-week period (P = 0.013). Walking speed also improved, but not significantly. Conclusion: Intensive gait training with the IRGO improved walking speed and the distance walked by paraplegics, as well as reducing the PCI of walking, as compared with baseline during the whole 12-week period. This indicates that further improvements in these parameters may be expected when utilizing gait training longer than 8 weeks.
Spinal Cord, 2016
Objective: Orthoses for various joints sections are considered to greatly influence the gait function and energy expenditure in spinal cord-injured (SCI) patients. The aim of this review was to determine the influence of orthoses characteristics and options on the improvement of walking in patients with SCI. Methods: A search was performed using the Population Intervention Comparison Outcome (PICO) method, based on selected keywords; studies were identified electronically in the Science Direct, Google Scholar, Scopus, Web of Knowledge and PubMed databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used to report the results. Assessment of the quality of all articles was performed based on the Physiotherapy Evidence Database (PEDro scale). Results: Twelve studies evaluated the effects of different hip joint options on walking parameters and energy expenditure. Five studies investigated the role of knee joint options on gait parameters and compensatory trunk motion. Only five studies analyzed modified ankle joints on gait parameters in SCI patients. Nine studies analyzed gait parameters in SCI patients as powered orthoses and exoskeleton. These studies had a low level of evidence according to the PEDro score (2/10). Conclusion: The various joint types of orthoses appear to be critical in the improvement of walking in patients with SCI. In particular, 'user friendly' orthoses that support the related structure such as the hip joint with a reciprocating mechanism, activated knee joint and movable ankle joint with dorsiflexion assist enable SCI patients to optimize their walking pattern when wearing an orthoses system.
Spinal Cord, 1997
The Walkabout orthosis is a relatively new device for assisted standing and mobility in spinal paralysed individuals. The design, with a medially-mounted single-axis hinge joint linking two knee-ankle-foot orthoses, is quite dierent to other currently available orthoses which have laterally positioned hip joints such as the Reciprocal Gait Orthosis or Hip Guidance Orthosis. Twenty-®ve spinal cord injured patients were ®tted and trained with the Walkabout orthosis and followed up regularly for just under 2 years on average. Sixty percent of all the patients ®tted have incorporated use of the Walkabout orthosis into their lifestyles. Maintenance of joint mobility and psychological bene®ts were the most important outcomes of Walkabout usage. Loss of thoraco-lumbar mobility was found to be a limiting factor in successful use of the Walkabout orthosis in patients without active hip¯exion. Patient selection criteria should include demonstrated spinal stability without signi®cant deformity, controlled muscle spasm, less than 58 of hip or knee¯exion contracture, achievable neutral ankle position, mobility of the thoraco-lumbar spine into lateral¯exion, good upper limb strength, and motivation with realistic expectations.
Reciprocating gait orthoses: A multicenter study of their use by spinal cord injured patients
Archives of Physical Medicine and Rehabilitation, 1997
Franceschini M, Baratta S, Zampolini M, Loria D, Lotta S. Reciprocating gait orthoses: a multicenter study of their use by spinal cord injured patients. Arch Phys Med Rehabil 1997;78:582-6. Objective: Use of reciprocating orthosis (RGO, ARGO, HGO) by 74 patients with complete traumatic spinal cord injury was studied. Lesion levels ranged from Tl to T12.
Spinal cord, 2000
To examine the influence of social, physical and psychological factors in determining the usage/non usage of reciprocating gait orthosis (RGO) in spinal cord injury (SCI) patients. Prospective clinical trial. A large rehabilitation hospital in Rome, Italy. Twenty four SCI patients of traumatic aetiology (all fulfilling the criteria to prescribe the device). Social, physical and neurological examination according to ASIA standards; psychological enquiry by means of the Eysenck Personality Questionnaire (EPQ) and the scale for self rating anxiety and depression of the Cognitive Behavioural Assessment. After 1 year follow up 11 (46%) of our patients no longer used the RGO. There was no statistically significant difference between patients who used the RGO and those who rejected the orthosis with regard to social and physical data. There was a significant difference (P=0.005 at the end of training and P=0.003 at 1 year follow up) with regard to functional ambulation level. With regard t...
Spinal Cord, 2012
Objectives: Mechanical orthoses, such as the hip knee ankle foot orthosis (HKAFO) and the isocentric reciprocating gait orthosis (IRGO), are both used for walking in spinal cord injury (SCI) patients. The aim of this study was to analyze the energy expenditure during walking with these orthoses compared with a powered gait orthosis (PGO) in patients with SCI. Methods: Five patients with SCI who were experienced users of HKAFOs participated in this study. Subjects were also fitted with an IRGO and PGO and underwent a specific gait training program. Patients walked along a flat walkway using the three types of orthosis at their self-selected walking speed. A stop watch and a polar heart rate monitor were used to measure the speed of walking and heart rate. Results: Walking speed, the distance walked and the physiological cost index (PCI) all improved with both the new PGO and the IRGO as compared with the HKAFO. Conclusions: A PGO can improve walking speed and the distance walked and reduce the PCI of walking as compared with mechanical orthoses, probably due to the activated movements of the lower limb joints.
Spinal Cord, 2003
Study design: Comparative study of the effectiveness of walking exercise with a newly developed gait orthosis, the weight-bearing control (WBC) orthosis, for thoracic level of paraplegic patients. Objectives: To test its feasibility as a rehabilitation alternative for paraplegic patients, the energy consumption and cost during walking with WBC were calculated and compared with the values of conventional orthoses given in previous reports. Setting: National Rehabilitation Center for the Disabled, Japan. Methods: Four paraplegic patients with traumatic spinal cord injuries ranging from T8 to T12 participated. Experiments were conducted after 3 months of the orthotic gait training with WBC. The cardiorespiratory parameters were continuously measured at rest and during walking with a telemetric device. The steady-state value of the oxygen uptake (V O 2 ), heart rate (HR), the energy consumption (J/kg/s) and energy cost (J/kg/m) were calculated. Results: The average walking speed was 19.072.58 m/min. The steady-state value of the V O 2 and HR were 16.0871.93 ml/kg and 147.3710.94 b/min, respectively. The energy cost during orthotic walking tended to be better than the values of conventional orthoses, whereas the energy consumption was almost similar. Conclusion: WBC enables thoracic level of paraplegic patients to walk at relatively higher speed than conventional orthoses under similar energy expenditure. The special devices equipped with WBC are therefore considered to lead to improvement of the energy cost of walking. The physical intensity presumed by cardiorespiratory responses during walking with WBC is suited to promote their aerobic capacity. Therefore, it is concluded that the WBC orthosis could be an effective alternative in rehabilitation for thoracic level of paraplegic patients.
JPO Journal of Prosthetics and Orthotics, 2017
Objectives Functional ability defines a person's ability to walk, with or without the aid of appropriate assistive devices, safely and sufficiently to carry out mobility-related activities of daily living. Longitudinal evaluation of the efficiency of gait training positively affecting these parameters has not been reported. Therefore, the aim of this study is to provide evidence supporting the progression of walking speed and functional ambulation over 12 weeks of orthotic gait rehabilitation using an isocentric reciprocating gait orthosis (IRGO) in patients with spinal cord injury (SCI). Materials and Methods Twelve patients with SCI participated in this study. Gait evaluation was performed at baseline and at 4, 8, and 12 weeks following intervention with an IRGO and specific gait training. Gait speed and endurance were measured by the 10-m walk test and the 6-minute walk test, respectively. The Functional Independence Measure (FIM) locomotor subscale and the Walking Index for ...
The use of an advanced reciprocating gait orthosis by paraplegic individuals: a follow-up study
Spinal Cord, 1997
This article describes the results of a follow-up study of 14 paraplegic individuals who were ®tted with the ARGO (Advanced Reciprocating Gait Orthosis ± STEEPER*) at least 1 year previously. It was found that 85% were still using the apparatus on a regular basis. The general satisfaction of the users was high, although the functional use was limited. Therapeutic reasons appeared to be the main reason for wearing the ARGO. The points that were most appreciated were the psychological and physiological bene®ts of standing and walking. Discussion with the users who were paraplegic provided valuable information concerning possible technical improvements to the ARGO.