Evaluation of a novel powered hip orthosis for walking by a spinal cord injury patient

Arazpour, Mokhtar; Chitsazan, Ahmad; Hutchins, Stephen W; Ghomshe, Farhad Tabatabai; Mousavi, Mohammad; Takamjani, Ismail Ebrahimi; Aminian, Gholamreza; Rahgozar, Mehdi; Bani, Monireh Ahmadi

doi:10.1177/0309364611431482

Cited by 24 publications

(33 citation statements)

References 14 publications

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“…Harvey et al 17 demonstrated that using the IRGO improved speed of walking as compared with the Walkabout orthosis. Arazpour et al 10,11 reported the using a powered hip orthosis and also a RGO improved kinematics and temporal spatial parameters as compared with the IRGO in a SCI patient. Kawashima et al 18 demonstrated that using the weight bearing control orthosis reduced energy consumption and improved speed of walking in paraplegic patients.…”

Section: Resultsmentioning

confidence: 99%

“…10,11 As compared with other type of hybrid systems such as functional electrical stimulation, 15 this system is considered effective according to the muscle fatigue previously demonstrated when using functional electrical stimulation. Although this comparison was not performed in this study, a comparison between the two approaches is proposed for further study.…”

Section: Resultsmentioning

confidence: 99%

“…8,9 The use of externally-applied power to specific orthotic joints within devices to assist movement and ambulation has therefore been proposed as an alternative approach in walking and reduced energy consumption in patients with SCI. 10,11 Different types of powered orthosis have been developed in recent years using pneumatic, hydraulic and electrical actuators. Many studies have been performed to compare the efficacy of such orthoses on the reduction of energy consumption between non-powered orthosis designs, 3,4,8 but comparison of this parameter between mechanical and powered orthoses has not been extensively evaluated.…”

Section: Introductionmentioning

confidence: 99%

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The physiological cost index of walking with mechanical and powered gait orthosis in patients with spinal cord injury

et al. 2012

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The physiological cost index of walking with mechanical and powered gait orthosis in patients with spinal cord injury

et al. 2012

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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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“…The R 2 GO reduced vertical displacement of the center of mass by 8 cm relative to that of an RGO in an individual with SCI and resulted in a more efficient pattern of horizontal pelvic rotation [10]. Other innovations involved the application of external power assistance to the RGO including direct current motors [11][12][13] and pneumatic artificial muscles [14] to help drive the reciprocal motion of the RGO. Such power-assisted RGOs decreased effort by users with SCI relative to walking with a standard RGO and have been shown to reduce the lateral and vertical compensatory motions involved in standard RGO gait [11,15].…”

Section: Introductionmentioning

confidence: 99%

Sensor-based hip control with hybrid neuroprosthesis for walking in paraplegia

Kobetic

Bulea

et al. 2014

J Rehabil Res Dev

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Abstract-The objectives of this study were to test whether a hybrid neuroprosthesis (HNP) with an exoskeletal variableconstraint hip mechanism (VCHM) combined with a functional neuromuscular stimulation (FNS) controller can maintain upright posture with less upper-limb support and improve gait speed as compared with walking with either an isocentric reciprocating gait orthosis (IRGO) or FNS only. The results show that walking with the HNP significantly reduced forward lean in FNS-only walking and the maximum upper-limb forces by 42% and 19% as compared with the IRGO and FNS-only gait, respectively. Walking speed increased significantly with VCHM as compared with 1:1 reciprocal coupling and by 15% when using the sensor-based FNS controller as compared with HNP with fixed baseline stimulation without the controller active.

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Evaluation of a novel powered hip orthosis for walking by a spinal cord injury patient

Cited by 24 publications

References 14 publications

The physiological cost index of walking with mechanical and powered gait orthosis in patients with spinal cord injury

The physiological cost index of walking with mechanical and powered gait orthosis in patients with spinal cord injury

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

Sensor-based hip control with hybrid neuroprosthesis for walking in paraplegia

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