Effect of powered gait orthosis on walking in individuals with paraplegia

Arazpour, Mokhtar; Bani, Monireh Ahmadi; Kashani, Reza Vahab; Ghomshe, Farhad Tabatabai; Mousavi, Mohammad; Hutchins, Stephen W

doi:10.1177/0309364612463164

Cited by 12 publications

(14 citation statements)

References 28 publications

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“…Twelve studies evaluated the effects of different hip joint options on walking parameters and energy expenditure. 5,[12][13][14][15][16][17][18][19][20][21][22] These studies had low level of evidence according to the PEDro score (2/10). Table 3 provides details on the studies evaluating modified hip joints in patients with SCI.…”

Section: Resultsmentioning

confidence: 99%

“…The means of speed of walking were reported 0.17, 0.19, 0.22, 0.25 and 0.34 m per second. 14,15,20,62,63 The mean of energy consumption was reported 120 ± 6 to 140 ± 11 beats per min) 144 beats per min. 14,62 In the modified hip joint category in using MLO, the values of this parameter were reported 0.11, 0.14, 0.33 m per second with WO, 16,26 0.13 with Moorong, 0.6 m per second with HALO 16,18 and 0.39 with new reciprocating MLO.…”

Section: Discussionmentioning

confidence: 99%

“…10 In another review, Arazpour et al reported on the walking efficiency of powered orthoses on walking in paraplegic subjects. 11 Although the effect of orthosis options in walking in paraplegic subjects is well reported, it is not clear to what extent the orthosis options for various joints sections influence gait function performance. The aim of the present review was to analyze the different orthosis with and without reciprocation mechanism or another type of exertion mechanism (for example, orthoses that modified hip joints, knee joints and ankle joints) and powered exoskeleton on the improvement of walking in the SCI patients.…”

Section: Introductionmentioning

confidence: 99%

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The influence of orthosis options on walking parameters in spinal cord-injured patients: a literature review

et al. 2016

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The influence of orthosis options on walking parameters in spinal cord-injured patients: a literature review

et al. 2016

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“…Although the effect of orthoses on walking in SCI patients has been reported, 22,[42][43][44] few publications have analysed the efficacy of PO compared with mechanical orthoses on energy expenditure in SCI subjects. PO were designed with the concept of providing active lowerextremity motion for SCI patient ambulation, especially those who are unable to swing their leg voluntarily, 45,46 and it has been demonstrated that temporal spatial parameters of walking can be improved with this type of orthosis compared with mechanical orthoses by providing active joint motions.…”

Section: Discussionmentioning

confidence: 99%

The efficiency of orthotic interventions on energy consumption in paraplegic patients: a literature review

et al. 2015

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Study design: This is a systematic literature review. Objectives: Different types of orthoses have been developed to enable and facilitate ambulation in individuals with paraplegia. However, their effect on energy consumption while ambulating is not clear. The objective of this review was to compare the energy expenditure required to walk with these devices. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method, and based on selected keywords and their composition according to the Population Intervention Comparison Outcome (PICO) method, a search was performed in Science Direct, Google Scholar, Scopus, Web of Knowledge and PubMed databases. The searches were restricted to papers published in the English language and were conducted during February 2014; the last access to the database was on 25 February 2014. A total of 24 articles were chosen for final evaluation. Results: Hybrid orthoses reduce energy consumption compared with mechanical orthoses when used for walking by paraplegic patients. The isocentric reciprocating gait orthosis has been shown to be more effective than other reciprocating orthoses in reducing energy consumption. Energy consumption when walking with powered orthoses (PO) and hybrid orthoses was also reduced compared with when walking with conventional orthoses. Conclusions: The hybrid orthoses and PO could be effective alternatives in rehabilitation for spinal cord injury patients to help improve the energy consumption. INTRODUCTIONThe ability to ambulate produces positive physiological and psychological effects for people with paraplegia. 1 Reduced incidence of osteoporosis, fractures, bedsores, spasticity, contractures and infection, as well as increased blood circulation, bowel and bladder performance, self-esteem, independence and more effective communication with people in society, are all examples of therapeutic reasons why paraplegic subjects should be able to walk. 2,3 Different types of mechanical orthoses have been developed to help individuals with paraplegia to ambulate, 4 such as hip-knee-ankle-foot orthoses (HKAFOs), reciprocating gait orthoses (RGOs), the hip guidance orthosis (HGO) and also medial linkage orthoses. 1 However, the use of mechanical orthoses is reducing because of high rejection rates owing to the high loads applied to upper limb joints and the high rate of energy expenditure experienced. 5 PO (which comprise a combination of mechanical orthoses and external actuators) and hybrid orthoses (a combination of mechanical orthoses and functional electrical stimulation) have been developed to improve walking and to reduce the effort required to ambulate by paraplegic subjects. 5 The use of external actuators and electrical stimulation of paralysed muscles has the potential to reduce energy consumption in paraplegic individuals during ambulation. 6

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“…10 In a comparison of different types of RGO in providing adequate walking speed by SCI patients, it has been reported that IRGO provides the highest speed. 1 Arazpour et al 17 reported a gait speed of 0.4 m s − 1 after 6 weeks of gait training with a powered gait orthosis in four SCI patients.…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

The influence of orthotic gait training with an isocentric reciprocating gait orthosis on the walking ability of paraplegic patients: a pilot study

et al. 2015

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Objectives: 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 re-training 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.

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Effect of powered gait orthosis on walking in individuals with paraplegia

Cited by 12 publications

References 28 publications

The influence of orthosis options on walking parameters in spinal cord-injured patients: a literature review

The influence of orthosis options on walking parameters in spinal cord-injured patients: a literature review

The efficiency of orthotic interventions on energy consumption in paraplegic patients: a literature review

The influence of orthotic gait training with an isocentric reciprocating gait orthosis on the walking ability of paraplegic patients: a pilot study

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