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Prosthet Orthot Int. 2016 Dec;40(6):696-702. Epub 2015 Jul 24.

The effect of trunk extension on physiological cost index in spinal cord injury patients when using the advanced reciprocating gait orthosis: A pilot study.

Author information

1
Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran.
2
Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
3
Loghman Hakim hospital, Shahid Beheshti University of Medical Sciences, Department of Neurosurgery, Tehran, Iran.
4
Department of Occupational Therapy, Mazandaran University of Medical Sciences, Sari, Islamic Republic of Iran gharib_masoud@yahoo.com.
5
Department of Occupational therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
6
IHSCR, Faculty of Health & Social Care, University of Salford, Manchester, Salford, UK.

Abstract

BACKGROUND:

People with spinal cord injury walk with a flexed trunk when using reciprocating gait orthoses for walking. Reduction in trunk flexion during ambulation has been shown to improve gait parameters for reciprocating gait orthosis users.

OBJECTIVE:

The aim of this study was to investigate the effect on energy expenditure when spinal cord injury patients ambulate with an advanced reciprocating gait orthosis while wearing a thoracolumbosacral orthosis to provide trunk extension.

STUDY DESIGN:

Quasi experimental study.

METHODS:

Four patients with spinal cord injury were fitted with an advanced reciprocating gait orthosis after completing a specific gait training program. Patients walked along a flat walkway using the advanced reciprocating gait orthosis as a control condition and also while additionally wearing a thoracolumbosacral orthosis at their self-selected walking speed. A stopwatch and a polar heart rate monitor were used to measure walking speed and heart rate.

RESULTS:

Walking speed, the distance walked, and the physiological cost index all improved when walking with the advanced reciprocating gait orthosis/thoracolumbosacral orthosis test condition compared to walking with no thoracolumbosacral orthosis in situ.

CONCLUSION:

Spinal cord injury patients can improve their walking speed, walking distance, and physiological cost index when wearing a thoracolumbosacral orthosis in conjunction with an advanced reciprocating gait orthosis, which may be attributed to the trunk extension provided by the thoracolumbosacral orthosis.

CLINICAL RELEVANCE:

It is concluded that wearing thoracolumbosacral orthosis in association with an advanced reciprocating gait orthosis could be an effective alternative in rehabilitation for thoracic level of paraplegic patients to promote their health and well-being.

KEYWORDS:

Paraplegia; advanced reciprocating gait orthosis; energy consumption; physiological cost index; spinal cord injury; walking

PMID:
26209422
DOI:
10.1177/0309364615592700
[Indexed for MEDLINE]

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