Effect of powered gait orthosis on walking in individuals with paraplegia

Background:The important purpose of a powered gait orthosis is to provide active joint movement for patients with spinal cord injury.Objectives:The aim of this study was to clarify the effect of a powered gait orthosis on the kinematics and temporal–spatial parameters in paraplegics with spinal cord injury.Study Design:Quasi-experimental.Methods:Four spinal cord injury individuals experienced gait training with a powered gait orthosis for a minimum of 6 weeks prior to participating in the following walking trials: walking with an isocentric reciprocating gait orthosis and walking with both separate and synchronized movements with actuated orthotic hip and knee joints in a powered gait orthosis. Specific parameters were calculated and compared for each of the test conditions.Results:Using separate and synchronized actuated movement of the hip and knee joints in the powered gait orthosis increased gait speed and step length and reduced lateral and vertical compensatory motions when compared to the isocentric reciprocating gait orthosis, but there were no significant differences in these parameters. Using the new powered gait orthosis improved knee and hip joint kinematics.Conclusions:The powered gait orthosis increased speed and step length as well as hip and knee joint kinematics and reduced the vertical and lateral compensatory motions compared to an isocentric reciprocating gait orthosis in spinal cord injury patients.Clinical relevanceThis new powered gait orthosis has the potential to improve hip and knee joint kinematics, the temporal–spatial parameters of gait in spinal cord injury patients walking.

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

Background: The aim of this case study was to analyze the effect on gait parameters of a new design of powered gait orthosis which applied synchronized motions to both the hip and knee joints when utilized for walking by a spinal cord injury (SCI) patient.Case Description and Methods: Two orthoses were evaluated while worn by an incomplete SCI subject. Gait evaluation was performed when walking with an isocentric reciprocating gait orthosis (IRGO) and compared to that demonstrated by a newly developed powered version. This new orthosis was based on the IRGO superstructure but incorporated powered hip and knee joints using electrically motorized actuators.Findings and Outcomes: These gait parameters were improved when compared to standard IRGO and initial testing with the orthosis with only the hip or the knee joints activated in isolation. Maximum hip flexion and extension angles, as well as the maximum knee flexion and extension angles all increased when walking with the powered RGO compared to the IRGO.Conclusions: Gait evaluation of this newly developed orthosis showed improvement in measured parameters when compared to walking with an IRGO.Clinical relevanceThis case study gave the authors confidence to extend the research to a more extensive study with a group of SCI patients.

Design and simulation of a new powered gait orthosis for paraplegic patients

Background and Aim: This article describes the development and testing of a new powered gait orthosis to potentially assist spinal cord injury patients to walk by producing synchronized hip and knee joint movements.Technique: The first evaluation of the orthosis was performed without users, and was followed by evaluation of the orthosis performance using three healthy subjects to test the structure under weight-bearing conditions. The orthosis was primarily evaluated to ascertain its ability to generate appropriate hip and knee motion during walking. The walking experiments replicated the flexion and extension of both the hip and knee produced by the actuators which had previously been demonstrated during the initial computer simulations.Discussion: The results suggest that this new orthosis could be used to assist paraplegic subjects who have adequate ranges of motion and also with weakness or reduced tone to ambulate, and may also be suitable for other subjects with impaired lower limb function (e.g. stroke, poliomyelitis, myelomeningocele and traumatic brain injury provided they do not have increased tone or movement disorders.Clinical relevanceThe new powered gait orthosis can provide walking assistance for patients with a spinal cord injury who have a good range of motion at the hip and knee and who also have weakness or reduced tone.