Abstract
Twenty-eight patients with complete T3-12 traumatic paraplegia were fitted with hip guidance orthosis (HGO, four cases), reciprocating gait orthosis (RGO, 13 cases) or advanced reciprocating gait orthosis (ARGO, 11 cases). Patients were enrolled for 2 months-6 years (median 5 months) in six Italian rehabilitation centres engaged in a common prospective protocol, including a 6 month follow up. After 12-84 (median 20) rehabilitation sessions over a 3-16 week (median 7) period of specific training all of the patients could perform don-doff manoeuvres autonomously in 2.5-15 min (median 6.4), and could walk at least 30 m with a walker (15 cases) or forearm crutches (13 cases) at 10-50 cm/s (median 16.6). HGO patients tended to walk more slowly than the others. None of them could walk upstairs, while three out of 13 RGO patients and seven out of 11 ARGO patients could. Six months later, 21 patients still used the orthosis for 0.5-3 h daily (median 2). Only four patients used the orthosis to walk outdoors. As a median they could still attain the speed recorded at discharge. Six patients had decided to abandon the device, while one was wheelchair bound due to a recent spinal intervention. Neither clinical, demographic or locomotor variables, nor centre and type of orthosis appeared to be predictive of abandonment of the device. During either the training or the follow up periods, six out of 13 RGO and seven out of 11 ARGO had to be repaired by the orthotist 1-10 times (median 3). Thus, in our sample of paraplegics, walking with these orthoses appeared to be a promising form of exercise rather than an alternative to wheelchair locomotion.
Similar content being viewed by others
Article PDF
References
Moore F (1989) The parawalker: walking for thoracic paraplegics. Physiother Pract 4: 18–22.
Beckham J (1987) The Louisiana State University Reciprocating Gait Orthosis. Physiotherapy 8: 24–30.
Lissene M A, Peeraer L, Goditiabois F, Lysens R (1990) Advanced reciprocating gait orthosis in paraplegic patients. (Abstract). In: Zupko JK et al, editors. Proceedings of the 7th World Congress, International Society for Prosthetics and Orthotics (ISPO), Chicago 1990: 31.
Winchester P K, Carollo J J, Parekh R N et al 1993 A comparison of paraplegic gait performance using two types of reciprocating orthosis. Prosthet Orthot Int 17: 101–108.
Frankel H L, Hancock D O, Hyslop G et al 1969 The value of postural reeducation in the management of closed injuries to the spine with paraplegia and tetraplegia. Paraplegia 7: 179–192.
Garrett M, Gronlet J, Nicholson D, Perry J (1987) Classification of levels of walking accomplishment in stroke patients. In: Van Aalte JAA, editor. CO MAC BME: Restoration of Walking Aided by FES. Edizioni Pro Juventute: 69–70.
McLelland 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.
Leo K (1985) The effects of passive standing. Paraplegia News 39: 45–47.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lotta, S., Fiocchi, A., Giovannini, R. et al. Restoration of gait with orthoses in thoracic paraplegia: a multicentric investigation. Spinal Cord 32, 608–615 (1994). https://doi.org/10.1038/sc.1994.96
Issue Date:
DOI: https://doi.org/10.1038/sc.1994.96
Keywords
This article is cited by
-
Energy consumption of paraplegic locomotion using reciprocating gait orthosis
European Journal of Applied Physiology and Occupational Physiology (1996)