Influence of reciprocating gait orthosis on walking function in paraplegic patients after ambulation☆◇

Abstract

AIM：To evaluate the application of reciprocating gait orthosis (RGO) combined with comprehensive rehabilitation exercises to restore the ambulation ability of paraplegic patients after spinal cord injury (SCI).

METHODS： ①Between March 2003 and June 2006, twenty paraplegic patients with complete SCI in T4－12 were fitted up with RGO successively in the Work Injury Rehabilitative Center of Guangdong Province. RGO included a pair of femoral articulation and two connected steels as the crucial, additionally with related torso and knee-ankle-foot orthosis.②Rehabilitative exercises comprising the range of motion, muscle strength, transferring and balancing items were conducted for 15－30 days, then RGO was equipped and followed by the trainings of wearing orthosis, standing-up and sitting-down, under parallel bar, walking exercises indoor and outdoor, twice daily, one hour once for 2 months continuously.③After training, the ambulation function of patients was examined and evaluated in a time limit, comprising mean step length, walking distance within 6 minutes and walking time for 10 m.

RESULT: All 15 patients entered the result analysis. Mean step length of 15 cases was (37.6±7.9) cm, mean walking distance within 6 minutes was (75.3±8.4) m, and mean walking time for 10 m was (54.9±4.6) s. Twelve cases had achieved household ambulation, and 5 of which fulfilled community ambulation. The other 3 cases achieved therapeutic ambulation.

CONCLUSION:①With the aid of RGO, patients suffered from complete SCI can achieve functional walking and improve the quality of life.②It is worthy of applying RGO in a wide range in clinical rehabilitation.

Sun JL, Tang D, Ouyang YT, Zhong SZ.Influence of reciprocating gait orthosis on walking function in paraplegic patients after ambulation.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2007;11(13):2437-2440(China)
[www.zglckf.com/zglckf/ejournal/upfiles/07-13/13k-2437(ps)pdf]

摘要
目的：观察应用重心移动式步行矫形器配合系统康复对脊髓损伤后截瘫患者步行功能的重建效果。
方法：①2003－03/2006－06，广东省工伤康复中心先后为15例T4～12节段完全性脊髓损伤患者安装自行研制的重心移动式步行矫形器，矫形器由一对髋关节、两个与髋关节连接的钢索作为其核心部分，外加与之相连接的上部躯干部分和下部大腿矫形器部分组成。②于安装前对其进行15~30 d综合康复训练，包括关节活动度、肌肉力量、平衡转移、站立等；装配后再进行矫形器穿戴训练、站起与坐下训练、平行杠内训练、室内平地步行训练和室外步行训练，2次/d，1 h/次，共训练2个月。③训练后对患者进行限时的步行功能检查和评价（包括平均步长，6 min步行距离及10 m步行时间）；并对其在治疗后所达到的步行功能状态进行定性评估。
结果：15例患者均进入结果分析。治疗后15例中12例达到功能性家庭内步行，其中5例达到功能性社区内步行，其余3例可作治疗性步行。其平均步长为（37.6±7.9）cm，6 min平均步行距离为（75.3±8.4） m，10 m平均步行时间为（54.9±4.6） s。
结论：①重心移动式步行矫形器能帮助T4以下完全性截瘫患者实现功能性步行，提高生活质量。②综合系统的康复训练是影响使用效果的重要因素。
关键词：脊髓损伤；截瘫；步行；重心移动式步行矫形器；康复工程

孙嘉利，唐丹，欧阳亚涛，钟世镇.重心移动式步行矫形器对截瘫患者步行功能的影响[J].中国组织工程研究与临床康复，2007，11(13):2437-2440 [www.zglckf.com/zglckf/ejournal/upfiles/07-13/13k-2437(ps).pdf]