Paraplegic locomotion: a review

Nene, A.V.; Hermens, Hermanus J.; Zilvold, G.

doi:10.1038/sc.1996.94

Cited by 57 publications

(46 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…3 ± 5 During the last decade great improvements in the ®eld of orthoses have been accomplished through the development of devices enabling the paraplegic individual to ambulate reciprocally. 6 These devices are more acceptable from an aesthetic point of view, easier to use and allow a more physiological gait pattern. 7 New e orts have been made to analyse the e ciency of paraplegic reciprocal walking, mainly regarding energy demands.…”

Section: Introductionmentioning

confidence: 99%

Walking with the Advanced Reciprocating Gait Orthosis (ARGO) in thoracic paraplegic patients: energy expenditure and cardiorespiratory performance

Massucci¹,

Brunetti²,

Piperno

et al. 1998

Spinal Cord

View full text Add to dashboard Cite

The aim of this study was to quantify the energy cost and the cardiorespiratory response while walking at free speed with an Advanced Reciprocating Gait Orthosis (ARGO). The study was conducted on a group of six male paraplegic patients, age range 16 ± 31 years (median = 22.50), with complete traumatic injuries ranging from T3 to T12 and a median time lapse from the trauma of 21 months. The data was recorded 6 ± 8 weeks after the patients were ®tted and trained to use the orthosis. Maintaining a standing position produced a signi®cant increase of both the heart rate (HR) and the respiratory rate (RR), whilst the increase of energy consumption was not signi®cant. The data for median speed, energy consumption and energy cost observed during free walking was similar to that of the Reciprocating Gait Orthosis (RGO) in thoracic level paraplegic individuals. This study indicates that in the utilisation of the ARGO the workload is not excessive when it is limited to maintaining a standing position. In contrast, walking results in early anaerobic conditions and unsustainable fatigue after short distances. The great energy cost recorded is considered to be a main reason for the frequent abandonment or the low utilisation of the orthosis at follow-up.

show abstract

Section: Introductionmentioning

confidence: 99%

Walking with the Advanced Reciprocating Gait Orthosis (ARGO) in thoracic paraplegic patients: energy expenditure and cardiorespiratory performance

Massucci¹,

Brunetti²,

Piperno

et al. 1998

Spinal Cord

View full text Add to dashboard Cite

show abstract

“…These systems in general were worn for a few hours in a week because of the high rate of energy consumption used during walking with these orthoses. 9 In comparison, Karimi noted differences between mechanical orthoses and hybrid orthoses in various kinetic parameters and energy consumption and stated that mechanical orthoses were more effective in providing stability and reducing energy consumption during walking in paraplegic patients. 10 In another review, Arazpour et al reported on the walking efficiency of powered orthoses on walking in paraplegic subjects.…”

Section: Introductionmentioning

confidence: 99%

“…In a review of mechanical and hybrid orthoses of walking in paraplegic patients, Nene et al 9 also noted that mechanical orthoses were used only for exercise purposes. These systems in general were worn for a few hours in a week because of the high rate of energy consumption used during walking with these orthoses.…”

Section: Introductionmentioning

confidence: 99%

The influence of orthosis options on walking parameters in spinal cord-injured patients: a literature review

et al. 2016

View full text Add to dashboard Cite

“…6 Arazpour et al, 1 when comparing the influence of PGOs, HGOs and mechanical orthoses (for example, RGOs and HGOs) in walking parameters and the energy efficiency of walking by spinal cord injury (SCI) patients, concluded that there was not enough evidence to show any superiority of currently developed PO over mechanical orthoses in improving walking parameters in SCI patients. Nene et al 7 stated that mechanical orthoses and hybrid orthoses were only used by paraplegic subjects for exercise purposes and only worn for a few hours per week because of the high rate of energy consumption experienced when walking with them. Waters and Mulroy 8 in a review of energy expenditure of normal and pathologic gait reported that walking speed and energy consumption improved between 0 and 10% when using hybrid orthoses compared with mechanical orthoses in SCI patients.…”

Section: Introductionmentioning

confidence: 99%

“…9 The overall analysis of orthotic devices (for example, mechanical orthoses, hybrid orthoses and PO) on energy consumption is therefore unclear. The objectives of this review were to compare the energy Nene et al 7 Three subjects with complete paraplegia with lesion level ranging from T5 toT7 Abbreviations: ARGO, advanced reciprocating gait orthoses; FES, functional electrical stimulation; FNS, functional neuromuscular stimulation; HR, heart rate; PCI, physiological cost index; PW, Para walker; RGO, reciprocating gait orthose; SCI, spinal cord injury T, thoracic; VO 2 , oxygen uptake.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2015

View full text Add to dashboard Cite

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

show abstract

Paraplegic locomotion: a review

Cited by 57 publications

References 38 publications

Walking with the Advanced Reciprocating Gait Orthosis (ARGO) in thoracic paraplegic patients: energy expenditure and cardiorespiratory performance

Walking with the Advanced Reciprocating Gait Orthosis (ARGO) in thoracic paraplegic patients: energy expenditure and cardiorespiratory performance

The influence of orthosis options on walking parameters in spinal cord-injured patients: a literature review

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

Contact Info

Product

Resources

About