Asian Spine J.  2019 Feb;13(1):96-102. 10.31616/asj.2017.0283.

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

• Samadian M
• Bani MA
• Golchin N
• Mardani MA
• Head JS
• Arazpour M

• KMID: 2441543
• DOI: http://doi.org/10.31616/asj.2017.0283

Abstract

STUDY DESIGN: Pilot study. PURPOSE: Evaluation of two different hip-knee-ankle-foot orthoses (HKAFOs; medial linkage reciprocating gait orthosis [MLRGO] and isocentric reciprocating gait orthosis [IRGO]) using gait and postural stability analysis in four subjects with spinal cord injury (SCI). OVERVIEW OF LITERATURE: To the best of our knowledge, no study has evaluated postural stability in subjects with SCI when using MLRGO and IRGO.
METHODS
The relative efficacy of each orthosis was evaluated with relevant gait parameters, and an assessment of postural stability and sway during usage was made. Each analysis was conducted following an appropriate period of training and acclimatization. The gait parameters employed in the study were walking speed, cadence, and endurance; these were recorded and analyzed using current, validated methods. Postural stability was assessed using a verified force plate measurement system, and a modified Falls Efficacy Scale (mFES) was used for the measurement of postural sway and the perceived fear of falling.
RESULTS
Walking speed, cadence, and endurance increased with the use of both HKAFOs. When the two types of HKAFOs were compared, all the parameters showed a slight (but not significant) increase with the use of MLRGO compared with the use of IRGO. In contrast, there were slight but insignificant improvements in postural sway with the use of IRGO. However, although there were no significant differences between the two sets of mFES scores, there was a slightly reduced fear of falling with the use of MLRGO compared with the use of IRGO in the static standing position.
CONCLUSIONS
It is noteworthy that meaningful interpretations of results can only be drawn if a larger sample is employed. This pilot study showed no significant data; however, the results indicate that the use of MLRGO is superior to that of IRGO in terms of potential improvement in the mobility and confidence levels of subjects with SCI.

Keyword

Isocentric reciprocating gait orthosis; Medial reciprocating gait linkage orthosis; Stability; Fear of falling

MeSH Terms

Accidental Falls
Acclimatization
Gait
Orthotic Devices*
Pilot Projects*
Posture
Spinal Cord Injuries*
Spinal Cord*
Walking