Orthoses for Spinal Cord Injury Patients

Abstract

There are some limitations for patients with spinal cord injury SCI when walking with assistive devices. Heavy energy expenditure and walking high loads on the upper limb joints are two main reasons of high rejection rate of orthosis by these patients . Many devices have been designed to enable people with paraplegia to ambulate in an upright position as a solution of these limitations such as mechanical orthoses, hybrid orthoses and powered orthoses. "ll these devices are designed to solve the problem of standing and walking, but there are some other important notes, which should be considered. For example, the size and weight of external orthoses, donning and doffing, cumbersomeness and independency for using are very important.

Orthoses in Spinal Cord Injury Rehabilitation Management and Improving Quality of Life

“…Two types of hybrid orthosis are available: one based on mechanical designs (HGO, RGO, ARGO) and the other based on new designs that are modular hybrid, wrapped spring clutch, and spring brake orthosis. Premature muscle fatigue, increased weight, and cumbersome mechanism of orthosis are the limitations of FES [12]. The lower limb exoskeleton with an inbuilt external power supply is also used in SCI ambulation.…”

“…The powered orthoses reduce the energy demands and effort during movement. However, its application for the mass population is poor due to its high cost and accessibility [12].…”

“…To achieve the power to walk is the main aim of orthotic management in SCI patients, which always depends on the level of injury and subsequently involved muscle powerlessness, sensory lack, spasticity, and lack of body control. The absence of motion in the hip, knee, and spastic ankle plantar flexion in the swing phase causes pathological gait [12]. Orthoses are medical devices that are applied externally to prevent contracture, increase function, maintain the functional position of a body segment, stabilize the body, and assist weak muscle, and its function/application results in increased motor control and balanced gait.…”

Recovery of Motor Function Following Spinal Cord Injury

“…Immunohistochemical analysis suggested the differentiation of transplanted cells into mature neurons as well as the intermingling of the host CNS with transplanted cells, as evidenced by NeuN/FOX-3 labeling. Despite interactions between host and donor cells, In contrast, Kobayashi and colleagues examined the safety and efficacy of iPSC-derived NSC transplants in a simian model of cervical SCI [210]. Human iPSCs were cultured and induced to form neurospheres and passaged a secondary and tertiary time prior to transplantation.…”