Article

Many patients who suffer from spinal cord injuries with paraplegia
cannot recover to walk independently. They need to use a special walking orthoses
to support their body to walk properly. Traditionally, long leg braces (LLB) were
fitted to patients for walking. Unfortunately, the results were not satisfactory
as this device supplies adequate support with less than optimum mobility. This
study used the latest reciprocating gait orthosis (RGO) combined with functional
electrical stimulation (FES). This combination provides a greater support range
while applying assistant mechanical walking structures. The FES co-ordination
helps restore natural walking abilities that the paralysed patient has lost.
METHOD: This study developed a walking orthosis with FES, using FES to stimulate
specific muscles (quadriceps, hamstring) in the paralysed patients' lower limbs.
The proposed method can achieve the benefits of physical therapeutics while
paralysed patients can achieve the purpose of walking. The FES is designed with
control buttons on the walking orthosis. A patient can control the left or right
leg in walking and speed control via the control buttons. RESULTS: Several
practical tests were conducted on the new walking orthosis. A 25-year-old female
paralysed patient (L1 complete spinal cord injury) used traditional LLB, RGO and
RGO with FES to proceed with walking rehabilitation and clinical assessment.
Heart rate difference (HRdifference), mean blood pressure (MBPdifference),
walking speed, length of steps, number of steps and oxygen consumption
comparisons were made before and after walking. The results show that RGO and RGO
with FES were both better than LLB. However, the differences between RGO and RGO
with FES in HRdifference, MBPdifference, and walking speed were not significant.
This is because the patient's right leg reaction to the electrical stimulation
was relatively low. DISCUSSION AND CONCLUSIONS: In general, RGO can help the
patient achieve quicker and more independent walking. The combination of RGO and
FES can increase the effectiveness of RGO for more mobile aid. These two walking
orthoses are better than traditional LLB. Both methods provide patients who
suffer from paraplegia with better choices.

Langue : ANGLAIS