The influence of trunk extension in using advanced reciprocating gait orthosis on walking in spinal cord injury patients: A pilot study

2014 ◽  
Vol 39 (4) ◽  
pp. 286-292 ◽  
Author(s):  
Mokhtar Arazpour ◽  
Masoud Gharib ◽  
Stephen William Hutchins ◽  
Monireh Ahmadi Bani ◽  
Sarah Curran ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Walking Speed ◽  
Step Length ◽  
Trunk Flexion ◽  
Gait Parameters ◽  
Cord Injury ◽  
Before And After ◽  
Spatial Parameters ◽  
Trunk Extension

Background:Spinal cord injury patients walk with a flexed trunk when using reciprocating gait orthoses. Reduction of trunk flexion during ambulation may produce an improvement in gait parameters for reciprocating gait orthosis users.Objectives:To investigate the effect on kinematics and temporal–spatial parameters when spinal cord injury patients ambulate with an advanced reciprocating gait orthosis while wearing a thoracolumbosacral orthosis to provide trunk extension.Study design:Comparative study between before and after use o thoracolumbosacral orthosis with the advanced reciprocating gait orthoses.Methods:Four patients with spinal cord injury were fitted with an advanced reciprocating gait orthosis and also wore a thoracolumbosacral orthosis. Patients walked along a flat walkway either with or without the thoracolumbosacral orthosis at their self-selected walking speed. Temporal–spatial parameters and lower limb kinematics were analyzed.Results:Mean walking speed, step length, and cadence all improved when walking with the thoracolumbosacral orthosis donned compared to the trunk support offered by the advanced reciprocating gait orthosis. Hip and ankle joint ranges of motion were significantly increased when wearing the thoracolumbosacral orthosis during ambulation.Conclusion:Using an advanced reciprocating gait orthosis when wearing a thoracolumbosacral orthosis can improve walking speed and the step length of walking as compared with walking with an advanced reciprocating gait orthosis, probably due to the extended position of the trunk.Clinical relevanceDonning the thoracolumbosacral orthosis produced a relatively extended trunk position in the advanced reciprocating gait orthosis for all the patients included in the study, which resulted in improved gait parameters.

Neuromuscular efficiency of men with high and low spinal cord injury levels compared with non-disabled participants

2020 ◽  
pp. 1-10
Author(s):  
Frederico Ribeiro Neto ◽  
Rodrigo Rodrigues Gomes Costa ◽  
Ricardo Antônio Tanhoffer ◽  
Josevan Cerqueira Leal ◽  
Martim Bottaro ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Latissimus Dorsi ◽  
Muscle Activation ◽  
Assessment Tool ◽  
Shoulder Abduction ◽  
Trunk Flexion ◽  
Flexion Extension ◽  
Cord Injury ◽  
Trunk Extension

BACKGROUND: The neuromuscular efficiency index (NME) is defined as the individual ability to generate force in relation to the muscle activation level and might be useful to the assessment of individuals with spinal cord injury (SCI) and might elucidate the modifications in strength after an SCI compared to non-disabled subjects (CG). OBJECTIVE: Verify if the NME of fully and partially preserved muscles discriminate men with low and high levels of SCI and a matched non-disabled CG. METHODS: Fifty-four men with SCI were stratified into the high (HP), and low (LP) paraplegia groups and twenty-seven non-disabled individuals were selected (CG). All subjects performed maximum strength tests in the isokinetic dynamometer for shoulder abduction/adduction (isokinetic) and trunk flexion/extension (isometric). Surface electromyography was measured to calculate the NME, and discriminant analysis was carried out to identify which NME variables would be able to discriminate HP, LP, and CG. RESULTS: There were no NME significant differences between groups for the primary muscles of the shoulder abduction/adduction. All NME data failed at discriminant tolerance test to compare HP from LP. The latissimus dorsi NME during trunk extension discriminated CG from HP and LP. CONCLUSIONS: The latissimus dorsi NME during trunk extension might be used as an assessment tool to compare SCI individuals and the non-disabled-matched controls. The authors recommend using the NME index for the analysis or comparisons between the same SCI levels.

The effect of trunk extension on physiological cost index in spinal cord injury patients when using the advanced reciprocating gait orthosis: A pilot study

2016 ◽  
Vol 40 (6) ◽  
pp. 696-702 ◽  
Author(s):  
Mokhtar Arazpour ◽  
Mohammad Samadian ◽  
Mahmood Bahramizadeh ◽  
Monireh Ahmadi Bani ◽  
Masoud Gharib ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Walking Speed ◽  
Well Being ◽  
Walking Distance ◽  
Cost Index ◽  
Physiological Cost ◽  
Cord Injury ◽  
Trunk Extension

Background:People with spinal cord injury walk with a flexed trunk when using reciprocating gait orthoses for walking. Reduction in trunk flexion during ambulation has been shown to improve gait parameters for reciprocating gait orthosis users.Objective:The aim of this study was to investigate the effect on energy expenditure when spinal cord injury patients ambulate with an advanced reciprocating gait orthosis while wearing a thoracolumbosacral orthosis to provide trunk extension.Study design:Quasi experimental study.Methods:Four patients with spinal cord injury were fitted with an advanced reciprocating gait orthosis after completing a specific gait training program. Patients walked along a flat walkway using the advanced reciprocating gait orthosis as a control condition and also while additionally wearing a thoracolumbosacral orthosis at their self-selected walking speed. A stopwatch and a polar heart rate monitor were used to measure walking speed and heart rate.Results:Walking speed, the distance walked, and the physiological cost index all improved when walking with the advanced reciprocating gait orthosis/thoracolumbosacral orthosis test condition compared to walking with no thoracolumbosacral orthosis in situ.Conclusion:Spinal cord injury patients can improve their walking speed, walking distance, and physiological cost index when wearing a thoracolumbosacral orthosis in conjunction with an advanced reciprocating gait orthosis, which may be attributed to the trunk extension provided by the thoracolumbosacral orthosis.Clinical relevanceIt is concluded that wearing thoracolumbosacral orthosis in association with an advanced reciprocating gait orthosis could be an effective alternative in rehabilitation for thoracic level of paraplegic patients to promote their health and well-being.

Effect of powered gait orthosis on walking in individuals with paraplegia

2012 ◽  
Vol 37 (4) ◽  
pp. 261-267 ◽  
Author(s):  
Mokhtar Arazpour ◽  
Monireh Ahmadi Bani ◽  
Reza Vahab Kashani ◽  
Farhad Tabatabai Ghomshe ◽  
Mohammad Ebrahim Mousavi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Knee Joint ◽  
Step Length ◽  
Joint Kinematics ◽  
Knee Joints ◽  
Powered Gait Orthosis ◽  
Cord Injury ◽  
Knee Joint Kinematics ◽  
Spatial Parameters

Background:The important purpose of a powered gait orthosis is to provide active joint movement for patients with spinal cord injury.Objectives:The aim of this study was to clarify the effect of a powered gait orthosis on the kinematics and temporal–spatial parameters in paraplegics with spinal cord injury.Study Design:Quasi-experimental.Methods:Four spinal cord injury individuals experienced gait training with a powered gait orthosis for a minimum of 6 weeks prior to participating in the following walking trials: walking with an isocentric reciprocating gait orthosis and walking with both separate and synchronized movements with actuated orthotic hip and knee joints in a powered gait orthosis. Specific parameters were calculated and compared for each of the test conditions.Results:Using separate and synchronized actuated movement of the hip and knee joints in the powered gait orthosis increased gait speed and step length and reduced lateral and vertical compensatory motions when compared to the isocentric reciprocating gait orthosis, but there were no significant differences in these parameters. Using the new powered gait orthosis improved knee and hip joint kinematics.Conclusions:The powered gait orthosis increased speed and step length as well as hip and knee joint kinematics and reduced the vertical and lateral compensatory motions compared to an isocentric reciprocating gait orthosis in spinal cord injury patients.Clinical relevanceThis new powered gait orthosis has the potential to improve hip and knee joint kinematics, the temporal–spatial parameters of gait in spinal cord injury patients walking.

scholarly journals Evaluation of a novel powered hip orthosis for walking by a spinal cord injury patient: a single case study

2012 ◽  
Vol 36 (1) ◽  
pp. 105-112 ◽  
Author(s):  
Mokhtar Arazpour ◽  
Ahmad Chitsazan ◽  
Stephen W Hutchins ◽  
Farhad Tabatabai Ghomshe ◽  
Mohammad Ebrahim Mousavi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Hip Joint ◽  
Single Case ◽  
Step Length ◽  
Spinal Cord Injury Patient ◽  
Positive Effects ◽  
Cord Injury ◽  
Spatial Parameters

Background: The aim of this case study was to identify the effect of a powered hip orthosis on the kinematics and temporal-spatial parameters of walking by a patient with spinal cord injury (SCI).Case Description and Methods: Two orthoses were evaluated while worn by an incomplete SCI subject with a T-8level of injury. Gait evaluation was performed when walking with an Isocentric Reciprocating Gait Orthosis (IRGO) and compared to that demonstrated by a newly powered version of the orthosis; based on the IRGO superstructure but incorporating powered hip joints using an electrically motorized actuator that produced active hip joint extension and flexion.Findings and Outcomes: The powered hip orthosis, when compared to the IRGO, increased the speed of walking, the step length and also the cadence demonstrated by this subject. Vertical and horizontal compensatory motions with new orthosis decreased. Hip angles when walking with this orthosis were comparative to those demonstrated by normal walking patterns.Conclusions: The hip actuator produced positive effects on the kinematics and temporal-spatial parameters of gait during level-ground walking trials, resulting in an alternative approach to walking by SCI patients.Clinical relevanceThis orthosis has the potential to improve hip joint kinematics, the temporal-spatial parameters of gait in SCI patients walking.

scholarly journals Gait Training Using a Wearable Robotic Device for Non-Traumatic Spinal Cord Injury: A Case Report

2020 ◽  
Vol 11 ◽  
pp. 215145932095696
Author(s):  
Kenichi Yoshikawa ◽  
Hirotaka Mutsuzaki ◽  
Kazunori Koseki ◽  
Yusuke Endo ◽  
Yuko Hashizume ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Walking Speed ◽  
Spinal Injury ◽  
Step Length ◽  
Gait Training ◽  
Walking Distance ◽  
American Spinal Injury Association ◽  
Flexor Muscle ◽  
Cord Injury

Introduction: We aimed to report the clinical evaluation results of gait training with the Honda Walking Assist Device® (HWAT) in a patient with spinal cord injury (SCI). Patients and Methods: A 63-year-old male with SCI (grade D on the American Spinal Injury Association Impairment Scale) underwent 20 HWAT sessions over 4 weeks. The self-selected walking speed (SWS), mean step length, cadence, 6-minute walking test (6MWT), Walking Index for SCI score, SCI Functional Ambulation Inventory gait score, American Spinal Injury Association Impairment Scale grade, neurological level, upper and lower extremity motor scores, modified Ashworth Scale, Penn Spasm Frequency Scale, and Spinal Cord Independence Measure version III were measured on admission, at the start of HWAT, at 2 and 4 weeks post-HWAT, and at discharge. Three-dimensional kinematic gait analysis and electromyographic assessments were performed before and after HWAT. Results: The patient safely completed 20 HWAT sessions. We found improvements above the clinically meaningful difference in SWS and 6MWT as well as increased hip extension, ankle plantar- and dorsi-flexion range of motion and increased hip extensor, abductor, adductor, and ankle plantar flexor muscle activity. Discussion: The SWS improved more markedly during the HWAT intervention, exceeding the minimal clinically important difference (0.10 to 0.15 m/s) in walking speed for people with SCI until discharge. Moreover, the 6MWT results at 2 weeks after the start of HWAT exceeded the cutoff value (472.5 m) for community ambulation and remained at a similar value at discharge. Conclusion: The walking distance (6MWT) and the walking speed (SWS) both demonstrated clinically important improvements following 20 treatment sessions which included HWAT.

Comparison of gait between healthy participants and persons with spinal cord injury when using the advanced reciprocating gait orthosis

2015 ◽  
Vol 40 (2) ◽  
pp. 287-293 ◽  
Author(s):  
Mokhtar Arazpour ◽  
Mahmoud Joghtaei ◽  
Mahmood Bahramizadeh ◽  
Monireh Ahmadi Bani ◽  
Stephen W Hutchins ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Range Of Motion ◽  
Ankle Joint ◽  
Step Length ◽  
Foot Orthoses ◽  
Normal Walking ◽  
Cord Injury ◽  
Ankle Foot Orthoses ◽  
Spatial Parameters

Background:The advanced reciprocating gait orthosis (ARGO) has a rigid structure which provides restricted movement at the hip, knee, and ankle joints and incorporates a pelvic section with an extended section in the lumbar region. Healthy subjects, when walking with an RGO in situ, could feasibly demonstrate the level of limitation in movement imposed by ARGO-assisted ambulation.Objective:The aim of this study was to compare the function of the advanced reciprocating gait orthosis when fitted with the dorsiflexion-assist ankle–foot orthoses on temporal–spatial parameters and kinematics of walking in both able-bodied people and those with spinal cord injury.Study design:Quasi experimental design.Methods:Data were acquired from six able-bodied and four spinal cord injury subjects who used an advanced reciprocating gait orthosis which incorporated dorsiflexion-assist ankle–foot orthoses. Kinematics and temporal–spatial parameters were calculated and compared.Results:All able-bodied individuals walked with speeds which were only approximately one-third that of when walking without an orthosis. The mean step length and cadence were both reduced by 48% and 6%, respectively. There were significant differences in hip, knee, and ankle joint range of motions between normal walking and walking with the advanced reciprocating gait orthosis both in able-bodied subjects and patients with spinal cord injury. There were also significant differences in the speed of walking, cadence, step length, hip range of motion, and ankle range of motion when using the advanced reciprocating gait orthosis between the two groups.Conclusion:Temporal–spatial parameters and lower limb sagittal plane kinematics of walking were altered compared to normal walking, especially when spinal cord injury subjects walked with the advanced reciprocating gait orthosis compared to the able-bodied subjects.Clinical relevanceTo produce an improvement in RGO function, an increase in walking performance should involve attention to improvement of hip, knee, and ankle joint kinematics, which differs significantly from normal walking.

Comparison of the effects of solid versus hinged ankle foot orthoses on select temporal gait parameters in patients with incomplete spinal cord injury during treadmill walking

2012 ◽  
Vol 37 (1) ◽  
pp. 70-75 ◽  
Author(s):  
Mokhtar Arazpour ◽  
Hamid Reza Tajik ◽  
Gholamreza Aminian ◽  
Monireh Ahmadi Bani ◽  
Farhad Tabatabai Ghomshe ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Step Length ◽  
Foot Orthoses ◽  
Incomplete Spinal Cord Injury ◽  
Gait Parameters ◽  
Significant Difference ◽  
Cord Injury ◽  
Ankle Foot Orthoses ◽  
The Mean

Background:Ankle foot orthoses (AFOs) are usually used for patients with incomplete spinal cord injury (ISCI) to provide support in walking.Objectives:The aim of this study was to compare the effect of AFOs, with and without ankle hinges, on specific gait parameters during treadmill training by subjects with ISCI.Study Design:Quasi-experimental.Methods:Five patients with ISCI at the thoracic level participated in this study. Gait evaluation was performed when walking 1) barefoot 2) wearing a solid AFO and 3) wearing a hinged AFO.Results:The mean step length when walking barefoot was 26.3 ± 16.37cm compared to 31.3 ± 17.27 cm with a solid AFO and 28.5 ± 15.86 cm with a hinged AFO. The mean cadence for walking barefoot was 61.59 ± 25.65 steps/min. compared to 50.94 ± 22.36 steps/min. with a solid AFO and 56.25 ± 24.44 steps/min with a hinged AFO. Significant differences in cadence and step length during walking were only demonstrated between the barefoot condition and when wearing a solid AFO. Significant difference was not observed between conditions in mean of ankle range of motion.Conclusion:The solid AFO was the only condition which improved cadence and step length in patients during ISCI gait training.Clinical relevanceA solid AFO could be used permanently to compensate for impaired ankle function or it could be used while retraining stepping.

scholarly journals Combination of defined CatWalk gait parameters for predictive locomotion recovery in experimental spinal cord injury rat models

eNeuro ◽  
2021 ◽  
pp. ENEURO.0497-20.2021
Author(s):  
Ivanna K. Timotius ◽  
Lara Bieler ◽  
Sebastien Couillard-Despres ◽  
Beatrice Sandner ◽  
Daniel Garcia-Ovejero ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Rat Models ◽  
Experimental Spinal Cord Injury ◽  
Gait Parameters ◽  
Cord Injury

37. H-reflex and F-wave of the patients of spinal cord injury before and after intrathecal baclofen injection

2010 ◽  
Vol 121 (7) ◽  
pp. e27
Author(s):  
Katsuhiro Mizuno ◽  
Kazushige Hasegawa ◽  
Osamu Uemura ◽  
Daisuke Matsuura ◽  
Masako Katahira ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Intrathecal Baclofen ◽  
H Reflex ◽  
Cord Injury ◽  
Before And After ◽  
F Wave
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