A comparison of the attitude of paraplegic individuals to the Walkabout Orthosis and the Isocentric Reciprocal Gait Orthosis

Abstract

This study compared the attitude of paraplegic individuals to the Isocentric Reciprocal Gait Orthosis (IRGO) and the Walkabout Orthosis (WO), after they had been given the opportunity of using both. Ten complete T 9 ± 12 paraplegic patients participated in this randomised cross-over design. Initially the subjects learned to walk with the ®rst orthosis before taking it home for a 14 week home trial period. The same process of training and trialing the orthosis at home was then repeated with the second orthosis. Attitudes to speci®c aspects of the orthoses were assessed by an 18 point questionnaire and overall attitudes were inferred after determining the amount of time that subjects used the orthoses at home and determining which orthosis the majority of subjects wanted to keep at the end of the study. The main ®nding was that subjects did not perceive any signi®cant dierences between the two orthoses. That is: (i) the questionnaire did not detect signi®cant dierences in attitudes to the two orthoses; (ii) there was no signi®cant dierence in the number of subjects that preferred one orthosis to the other, at the end of the study, and (iii) subjects did not derive more use from one orthosis than the other over the two 14 week home trial periods. In addition, it was found that few subjects wore either orthosis more than once every 2 weeks and that subjects were primarily using the orthoses for therapeutic purposes. This latter ®nding was supported by the results of the questionnaire that revealed that subjects found both orthoses to be useful for standing but not useful for performing more purposeful tasks. It was concluded that when subjects are primarily using the WO and IRGO for therapeutic purposes, they do not readily perceive dierences between the two.

Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: systematic review, qualitative study, survey and costing analysis

“…Nine studies 53,57,59,62,[64][65][66][67][68] (Table 11) assessed the effects of orthoses on patients with knee instability following spinal cord injury (194 patients). Two of the studies 64,67 were conducted in the UK.…”

“…Sample sizes were small, ranging from 5 61 to 67 69 participants with 11 studies having 20 or fewer participants (see Table 1). Eight of the studies reported knee instability as a result of NMD (153 patients) 45,47,49,50,52,56,61,63 (all except one study 45 being of patients with post-polio syndrome) and 13 reported knee instability resulting from CNS causes (325 patients), 48,53,[57][58][59][60]62,[64][65][66][67][68][69] either post stroke or spinal cord injury.…”

“…Seventeen studies were published in English, 45,[47][48][49][50]52,53,[56][57][58][59][60][61][62]64,67,68 three in Chinese 65,66,69 and one in German. 63 The studies in languages other than English were extracted by a native speaker who was also a researcher with experience of undertaking systematic reviews.…”

“…Adverse effects were not investigated or not reported in 17 studies. 45,[47][48][49][50]52,53,[59][60][61][62][63][65][66][67][68][69] We planned to extract data to allow calculation of between-group differences and confidence intervals. However, because of the generally poor reporting of data, it was not possible to consistently do this across studies.…”

Role of Gait Training in Recovery of Standing and Walking in Subjects with Spinal Cord Injury

“…In addition in another study, Harvey et al demonstrated that stand up and sit down with WO was easier than IRGO, but IRGO provided faster and more independent ambulation [34]. In comparison of the attitude of subjects with SCI when using WO and the IRGO, Harvey et al reported few subjects used orthosis more than once every 2 weeks, and SCI individuals were primarily wearing the orthoses for therapeutic aims [35]. To evaluate the influence of Primewalk orthosis and walkabout orthosis in improving the walking performance in subjects with SCI, Ongio et al demonstrated the Primewalk orthosis had better effect in walking efficiency than that of the Walkabout orthosis [36].…”