Comparative study of conventional knee-ankle-foot orthoses versus isocentric reciprocating gait orthoses for paraplegic patients

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Comparative study of conventional knee-ankle-foot orthoses versus isocentric reciprocating gait orthoses for paraplegic patients

 

Author: Wong, Fong-yee
Title: Comparative study of conventional knee-ankle-foot orthoses versus isocentric reciprocating gait orthoses for paraplegic patients
Degree: M.Sc.
Year: 2003
Subject: Hong Kong Polytechnic University -- Dissertations
Orthopedic apparatus
Paraplegics -- Rehabilitation
Prosthesis
Human mechanics
Department: Jockey Club Rehabilitation Engineering Centre
Pages: ix, 84 leaves : ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1724868
URI: http://theses.lib.polyu.edu.hk/handle/200/4967
Abstract: Objectives: To evaluate and compare the functional outcome and physiological cost index (PCI) in low-thoracic paraplegic subjects during the usage of Knee-Ankle-Foot Orthosis (KAFO) and Isocentric Reciprocating Gait Orthosis (IRGO). Design: Within subject comparison between 2 different orthotic interventions. Setting: Rehabilitation hospital. Walking tests on PCI were done on an 40-meter rectangular indoor walking track. Participants: Six motor complete chronic paraplegic subjects with lesion between T10 and L1. Intervention: Six subjects were fitted with IRGO and then received a standardized training programme for IRGO walking. It included upper limbs strengthening exercises, balance training, gait training and functional skills training. The training programme was lasted for 6 to 8 weeks and was 3 times per week. The total training duration ranged from 36 to 48 hours. All subjects were skilled KAFO's users. They were encouraged to have regular standing and walking practices at home before testing. Main outcome measures: Average walking speed and heart rate were measured during each 6 minutes walking trial. Physiological cost index (PCI) was calculated under steady-state condition in the last 2 minutes of a trial. Spinal Cord Independent Measure (SCIM) was used for functional mobility performance measurement. Results: There was a statistically significant difference in walking speed and PCI between the two types of orthotic conditions (p=0.009 and 0.030 respectively). KAFO's walking took more than twice the effort (mean PCI: 6.77 beats/m) of IRGO walking (mean PCI: 2.58 beats/m). IRGO walking was faster (mean velocity: 10.46m/min), requiring almost half the speed of KAFOs walking (mean velocity: 5.51m/min). Standing heart rate and SCIM scoring of functional performance of the two conditions were similar, but the percentage change of standing heart rate was lower in the IRGO group. Conclusion: Similar to other orthotic devices for the spinal cord injuried individuals, IRGO walking was slower and less energy efficient than normal walking. However, the IRGO intervention provided a better performance than the KAFO intervention that are commonly prescribed to the T12-L1 spinal cord injured population. Comparing to the KAFO condition, both walking speed and PCI were improved in the IRGO condition.

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