Article

The most simple and common approach in providing standing and walking
by subjects with spinal cord injury (SCI) is the use of mechanical orthoses.
These include traditional orthoses, medial linkage orthoses (MLOs) and
reciprocating gait orthoses (RGOs). Independence, energy expenditure, gait
parameters, system reliability and cosmesis are important factors in orthotic
design. The aim of this review was to compare the evidence of existing mechanical
orthoses to that of other types regarding these factors.
METHODS: The preferred
reporting items for systematic reviews and meta-analyses (PRISMA) method was used
by an experience researcher based on selected keywords and their composition and
an electronic search was performed in well-known databases. RESULTS: Twenty
articles were selected for final evaluation. Many were case studies, and also had
limited and heterogeneous sample sizes with different instruments used for
evaluation. The results of the analysis demonstrated that independence and
cosmesis are improved when using MLOs, but gait parameters, energy expenditure
and stability are all improved when using RGOs. CONCLUSION: Those mechanical
orthoses which have reciprocal motion and congruency between the anatomical and
orthotic joints have been shown to provide positive effects on patient
lifestyles. However, further improvement is needed to more effectively meet the
needs of SCI patients. IMPLICATIONS FOR REHABILITATION: 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.

Langue : ANGLAIS