Leung, A, Wong, A, Wong, E and Hutchins, S 2009, 'The physiological cost index of walking with an isocentric reciprocating gait orthosis among patients with T12–L1 spinal cord injury' , Prosthetics and Orthotics International, 33 (1) , pp. 61-68.

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Abstract

Objective: The objective of this study was to compare the Physiological Cost Index of walking with a reciprocating gait orthosis to that of walking with bilateral knee-ankle-foot orthoses (KAFOs) by subjects with paraplegia resulting from T12 – L1 spinal cord lesions. Methodology: Six chronic paraplegic subjects who had T12 – L1 spinal cord lesions and who previously wore bilateral KAFOs were recruited. Each subject was fitted with an isocentric reciprocating gait orthosis (IRGO) and received a standardized training program. Subjects were then asked to walk using the two orthotic devices along a 40 m rectangular pathway at a speed that was comfortable for them. The walking speed was measured using a stop watch, and a Polar Heart Rate Monitor was used to measure the heart rate of the subjects. The Physiological Cost Index (PCI) was calculated for comparison. Results: Ambulation using the IRGO (10.46þ/72.00 m/min) was significantly faster (p¼0.009) than ambulation using the bilateral KAFOs (5.51þ/74.30 m/min). The PCI demonstrated when walking with the IRGO (2.85þ/70.77 beats/m) was significantly lower (p¼0.0306) than that of the bilateral KAFOs (6.77þ/73.28 beats/m). Conclusion: Paraplegic patients with T12 – L1 spinal cord lesions walk faster and more efficiently using the isocentric reciprocating gait orthosis as compared to using the bilateral KAFOs.

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