Assessment of functional capacity during gait using a reciprocal propulsion orthosis (ARGO): a comparative study with a conventional mechanical orthosis

Muszkat, R; Yazbek, Paulo; Arango, Claudia T.; Moreira, Maria Cecília dos Santos; Trombetta, lvani C.; Battistella, Linamara Rizzo

doi:10.1590/s1516-31801994000100004

Cited by 4 publications

(2 citation statements)

References 5 publications

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“…The two poor-quality studies in this group according to PEDro scale (1/10) performed by Middleton et al 30 and Muszkat et al 31 Middleton et al 30 in a comparison between different types of medial linkage orthoses on one SCI subject from C6 level of injury showed that there was no significant difference between the Moorong and WO in PCI values when walking along a level surface (11.5 beat per m); however, the Moorong orthosis provided increased speed of walking compared with WO during ambulation. Muszkat et al 31 in a comparison between ARGOs and HKAFOs in one SCI subject with C6 level of injury reported that the ARGO needed less energy expenditure during ambulation (0.9 versus 0.82).…”

Section: The Effect Of Mechanical Orthoses On Energy Consumption In Pmentioning

confidence: 98%

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The efficiency of orthotic interventions on energy consumption in paraplegic patients: a literature review

et al. 2015

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Study design: This is a systematic literature review. Objectives: Different types of orthoses have been developed to enable and facilitate ambulation in individuals with paraplegia. However, their effect on energy consumption while ambulating is not clear. The objective of this review was to compare the energy expenditure required to walk with these devices. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method, and based on selected keywords and their composition according to the Population Intervention Comparison Outcome (PICO) method, a search was performed in Science Direct, Google Scholar, Scopus, Web of Knowledge and PubMed databases. The searches were restricted to papers published in the English language and were conducted during February 2014; the last access to the database was on 25 February 2014. A total of 24 articles were chosen for final evaluation. Results: Hybrid orthoses reduce energy consumption compared with mechanical orthoses when used for walking by paraplegic patients. The isocentric reciprocating gait orthosis has been shown to be more effective than other reciprocating orthoses in reducing energy consumption. Energy consumption when walking with powered orthoses (PO) and hybrid orthoses was also reduced compared with when walking with conventional orthoses. Conclusions: The hybrid orthoses and PO could be effective alternatives in rehabilitation for spinal cord injury patients to help improve the energy consumption. INTRODUCTIONThe ability to ambulate produces positive physiological and psychological effects for people with paraplegia. 1 Reduced incidence of osteoporosis, fractures, bedsores, spasticity, contractures and infection, as well as increased blood circulation, bowel and bladder performance, self-esteem, independence and more effective communication with people in society, are all examples of therapeutic reasons why paraplegic subjects should be able to walk. 2,3 Different types of mechanical orthoses have been developed to help individuals with paraplegia to ambulate, 4 such as hip-knee-ankle-foot orthoses (HKAFOs), reciprocating gait orthoses (RGOs), the hip guidance orthosis (HGO) and also medial linkage orthoses. 1 However, the use of mechanical orthoses is reducing because of high rejection rates owing to the high loads applied to upper limb joints and the high rate of energy expenditure experienced. 5 PO (which comprise a combination of mechanical orthoses and external actuators) and hybrid orthoses (a combination of mechanical orthoses and functional electrical stimulation) have been developed to improve walking and to reduce the effort required to ambulate by paraplegic subjects. 5 The use of external actuators and electrical stimulation of paralysed muscles has the potential to reduce energy consumption in paraplegic individuals during ambulation. 6

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Section: The Effect Of Mechanical Orthoses On Energy Consumption In Pmentioning

confidence: 98%

“…Muszkat et al 31 in a comparison between ARGOs and HKAFOs in one SCI subject with C6 level of injury reported that the ARGO needed less energy expenditure during ambulation (0.9 versus 0.82).…”

Section: The Effect Of Mechanical Orthoses On Energy Consumption In Pmentioning

confidence: 99%

The efficiency of orthotic interventions on energy consumption in paraplegic patients: a literature review

et al. 2015

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Comparative trials on hybrid walking systems for people with paraplegia

IJzerman

Baardman

Hermens

et al. 1999

Prosthetics &Amp; Orthotics International

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A new orthosis (SEPRIX) which combines user friendliness with low energy cost of walking has been developed and will be subject to a clinical comparison with conventional hip-knee-ankle-foot orthoses. In designing such comparative trials it was considered it may be worthwhile to use previous clinical studies as practical examples. A literature search was conducted in order to select all comparative trials which have studied two walking systems (hip-knee-ankle-foot orthoses) for patients with a complete thoracic lesion. Study population, intervention, study design, outcome measurement and statistical analyses were examined. Statistical power was calculated where possible. Of 12 selected studies, 7 were simple A-B comparisons, 2 A-B comparisons with a replication, 2 cross-over trials and 1 non-randomised parallel group design, the last of which was considered internally invalid due to severe confounding by indication. All A-B comparisons were considered internally invalid as well, since they have not taken into account that a comparison of two orthoses requires a control for aspecific effects (like test effects) which may cause a difference. Statistical power could only be examined in 4 studies and the highest statistical power achieved in one study was 47 %. It is concluded that statistical power was too low to be able to detect differences. Even analysis through interval estimation showed that the estimation of the difference was too imprecise to be useful. Since the majority of the surveyed papers have reported small studies (of only 4–6 patients), it is assumed that lack of statistical power is a more general problem. Three possibilities are discussed in order to enhance statistical power in comparative trials, i.e. multicentre studies, statistical pooling of results and improving the efficiency of study design by means of interrupted time series designs.

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The efficiency of mechanical orthoses in affecting parameters associated with daily living in spinal cord injury patients: a literature review

Bani

Arazpour

Farahmand

et al. 2014

Disability and Rehabilitation: Assistive Technology

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The most simple and traditional approach to enable standing and walking by people with SCI is use of purely mechanical orthoses. The most important factors that increase rejection rates of orthoses in paraplegia patients are excessive energy expenditure and increased applied force on upper limb joints. Improvement of the structure of mechanical orthoses is needed to improve independence, energy expenditure, and gait parameters, and is an important approach to improve ambulatory function in subjects with paraplegia.

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Assessment of functional capacity during gait using a reciprocal propulsion orthosis (ARGO): a comparative study with a conventional mechanical orthosis

Cited by 4 publications

References 5 publications

The efficiency of orthotic interventions on energy consumption in paraplegic patients: a literature review

The efficiency of orthotic interventions on energy consumption in paraplegic patients: a literature review

Comparative trials on hybrid walking systems for people with paraplegia

The efficiency of mechanical orthoses in affecting parameters associated with daily living in spinal cord injury patients: a literature review

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