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  4. Effects of Two Different Hip-Knee-Ankle-Foot Orthoses on Postural Stability in Subjects with Spinal Cord Injury: A Pilot Study

Effects of Two Different Hip-Knee-Ankle-Foot Orthoses on Postural Stability in Subjects with Spinal Cord Injury: A Pilot Study

Asian Spine J, 2019 · DOI: 10.31616/asj.2017.0283 · Published: January 1, 2019

Spinal Cord InjuryAssistive TechnologyRehabilitation

Simple Explanation

This study evaluates two types of leg braces (orthoses) that help people with spinal cord injuries (SCI) stand and walk: the medial linkage reciprocating gait orthosis (MLRGO) and the isocentric reciprocating gait orthosis (IRGO). The researchers looked at how stable people were while standing and walking with each brace, as well as how fast and far they could walk. The study found that both braces improved walking speed and endurance, but there were no significant differences between the two in terms of stability or fear of falling.

Study Duration
8 weeks gait training program
Participants
4 subjects with SCI and sensory incomplete lesions
Evidence Level
Pilot study

Key Findings

  • 1
    Walking speed, cadence, and endurance increased with the use of both HKAFOs; the increase was slightly higher with the use of MLRGO than with the use of IRGO.
  • 2
    There was no significant difference in the mFES scores (p=0.066) with the use of the two types of orthoses
  • 3
    The use of IRGO limited postural sway compared with the use of MLRGO

Research Summary

This pilot study investigated the efficacy of IRGO and MLRGO on postural sway, modified Falls Efficacy Scale (mFES), and gait during ambulation in four subjects with SCI. The results of this pilot study show no advantages of using MLRGO over IRGO. However, this could be attributed to the considerable heterogeneity among subjects and the relatively low sample size The present results indicate that the use of MLRGO may result in greater improvements in walking speed and endurance in patients with SCI than the use of IRGO, although the differences are too small to be considered significant at this stage.

Practical Implications

Future Research

Larger studies are needed to confirm if MLRGO can improve mobility and confidence in SCI patients compared to IRGO.

Clinical Practice

When choosing an orthosis, consider factors like ease of use and individual needs, not just stability.

Orthotic Design

Further research should focus on orthotic designs that balance stability with user independence and confidence.

Study Limitations

  • 1
    Small sample size
  • 2
    Considerable heterogeneity among subjects
  • 3
    Inconclusive data

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