Walking for paraplegics with complete mid-thoracic lesions is now becoming a clinically viable reality. However, much of the literature in this field overstates the achievements and masks the difficulties that patients may encounter.
This paper highlights Independence, Energy Cost, Cosmesis, Reliability and Cost as the five areas of prime interest involved in the design compromise for any walking system and urges that all relevant information for any system should be readily available to prescribers. Currently available walking systems are briefly considered.
Andrews B J, Bajd T 1985 Paraplegic locomotions: hybrid FES approach. Conference on Medical and Biological Engineering and Medical Physics. ESPOO, Finland 11–16 August.
Bajd T, Kralj A, Turk R, et al. 1983 The use of a four-channel electrical stimulator as an ambulatory aid for paraplegic patients. Physical Therapy 63(7): 1116–1120.
Beckmann J 1987 The Louisiana State University Reciprocating Gait Orthosis. Physiotherapy 73(8):386–392.
Butler P B, Major R E 1987 The ParaWalker: A rational approach to the provision of reciprocal ambulation for paraplegic patients. Physiotherapy 73(8):393–397.
Kralj A, Grobelnik S 1973 Functional stimulation—A new hope for paraplegic patients? Bulletin of Prosthetic Research Fall: 75–102.
Marsolais E B, Kobetic M S 1986 Implantation techniques and experience with percutaneous intramuscular electrodes in the lower extremities. Journal of Rehabilitation in Research and Development 23(3): 1–8.
McClelland M, Andrews B J, Patrick J H, et al. 1987 Augmentation of the Oswestry ParaWalker orthosis by means of surface electrical stimulation: Gait analysis of three patients. Paraplegia 25: 32–38.
Merritt J L 1987 Knee-ankle-foot orthosis, long leg braces and their practical applications. Physical Medicine and Rehbailitation: State of the Art Review 1(1):67–82.
Nene A, Patrick J H 1986 Energy cost of paraplegic locomotion with the ORLAU ParaWalker. Paper read at the Scientific Meeting International Medical Society of Paraplegia, Stoke Mandeville, May.
Patrick J H, McClelland M R 1985 Low energy reciprocal walking for the adult paraplegic. Paraplegia 23: 113–117.
Petrofsky J S, Phillips C A 1983 Computer controlled walking in the paralysed individual. Journal of Neurological and Orthopaedic Medicine and Surgery 4(2):153–164.
Petrofsky J S, Phillips C A, Larson P, et al. 1985 Computer synthesised walking: An application of orthosis and functional electrical stimulation (FES). Journal of Neurological and Orthopaedic Medicine and Surgery 6(3):219–230.
Rose G K 1980 Orthoses for the severely handicapped—rational or empirical choice. Physiotherapy 66: 76–81.
Rose G K 1986 Orthotics: Principles and practice. William Heinemann Medical Books London, pp. 47–48.
Stallard J, Major R E, Poiner R, et al. 1986 Engineering design considerations of the ORLAU ParaWalker and FES hybrid system. Engineering in Medicine 15(3): 123–129.
Vossius G 1985 Common aspects of functional electrical stimulation. Proceedings of the EEC COMAC/BME Topical Workshop ‘Restoration of Walking for Paralysed Persons’, pp 27–28.
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Stallard, J., Major, R. & Patrick, J. A review of the fundamental design problems of providing ambulation for paraplegic patients. Spinal Cord 27, 70–75 (1989). https://doi.org/10.1038/sc.1989.11
- FES (Functional Electrical Stimulation)
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