Development of a Hybrid Gait Orthosis: A Case ReportBy Kobetic, Rudi, MS; Marsolais, E. Byron, MD, PhD; Triolo, Ronald J., PhD; Davy, Dwight T., PhD; Gaudio, Richard; Tashman, Scott, PhD; Journal of Spinal Cord Medicine, Vol. 26, No. 3, pp. 254-258
Publication Date: Fall 2003
Study conducted to improve stability, posture, and gait speed in an individual with paraplegia through the application of a hybrid system including trunk-hip-knee-ankle-foot orthosis (THKAFO) with lockable joints and multichannel functional electrical stimulation (FES) with implanted electrodes. A 55-year-old man with T-9 complete thoracic spinal cord injury participated in the study. Two hybrid orthoses were implemented and evaluated on a participant with a complete absence of motor function and sensation below the T-9 spinal level. The first hybrid was a modified isosentric reciprocal gait orthosis (IRGO) with the knees controlled by FES, the ankles fixed at neutral, and the hips coupled with a reciprocator. The second hybrid hand a THKAFO instrumented with lockable joints using wrap-spring clutches at the hips and knees. A microprocessor-controlled stimulator provided muscle stimulation and activation signals for the solenoids. The two hybrid systems were compared with an FES system. The IRGO hybrid system with the hip reciprocator engaged provided a stable gait with erect posture with minimal anterior trunk lean using only quad canes for support. The walking speed was slow due to limited step length imposed by the reciprocator. The results suggest a need for a hybrid system that allows for unencumbered hip and knee joint motion for stepping without excessive anterior trunk lean.
Published by: American Paraplegia Society (Website:http://www.apssci.org)
This publication is included in the library of the National Rehabilitation Information Center (NARIC), accession number J46251