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新型内侧联动矫形器对脊髓损伤患者步行及独立性的影响:一项初步研究。

The influence of new medial linkage orthosis on walking and independence in spinal cord injury patients: a pilot study.

作者信息

Bani Monireh Ahmadi, Arazpour Mokhtar, Farahmand Farzam, Mousavi Mohammad Ebrahim, Samadian Mohammad, Kashani Reza Vahab, Hutchins Stephen William

机构信息

Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences , Tehran, Iran.

Department of Mechanical Engineering, Sharif University of Technology , Tehran, Iran.

出版信息

Spinal Cord Ser Cases. 2016 Apr 7;2:15033. doi: 10.1038/scsandc.2015.33. eCollection 2016.

Abstract

In an effort to overcome the disadvantages of reciprocating gait orthoses (RGOs) and medial linkage orthoses (MLOs), a new design of MLO was developed. Therefore the aim of this study was comparison effect of a new reciprocating MLO and traditional isocentric RGO on gait parameters and functional independence (orthosis donning and doffing time) in spinal cord injury (SCI) subjects to provide more evidence of its efficacy. Four people with motor incomplete SCI participated in this study. Each participant was fitted with an MLO and isocentric reciprocating gait orthosis (IRGO) to enable a comparison of walking speed, cadence and endurance to be performed. There were no statistically significant differences demonstrated in temporal-spatial parameters between the orthotic walking conditions in this study, but walking with the MLO improved the stride length and speed of walking by 28.57 and 40.9% compared with walking with an IRGO as a control condition. Hip flexion occurred predominantly during single-support phases, with negligible motion during double-support phases. The first and second Subjects had hip kinematic pattern more near normal when they walked with medial linkage reciprocal gait orthosis (MLRGO) in comparison with IRGO. There was significant difference between donning and doffing in two conditions (=0.046) but there was not significant difference between two conditions in standing and sitting although these two conditions improved by new MLO. The new MLO provided a quicker and more independent gait compared with IRGO, in addition the new MLO made it easier for subjects to get from sitting to standing and from standing to sitting.

摘要

为了克服往复式步态矫形器(RGO)和内侧联动矫形器(MLO)的缺点,研发了一种新型MLO设计。因此,本研究的目的是比较新型往复式MLO与传统同心RGO对脊髓损伤(SCI)患者步态参数和功能独立性(矫形器穿戴和脱卸时间)的影响,以提供更多其有效性的证据。四名运动不完全性SCI患者参与了本研究。每位参与者都佩戴了MLO和同心往复式步态矫形器(IRGO),以便能够比较步行速度、步频和耐力。本研究中,不同矫形器步行条件下的时空参数没有显示出统计学上的显著差异,但与作为对照条件的IRGO步行相比,使用MLO步行时步长和步行速度分别提高了28.57%和40.9%。髋关节屈曲主要发生在单支撑期,双支撑期的运动可忽略不计。与IRGO相比,第一名和第二名受试者在使用内侧联动往复式步态矫形器(MLRGO)行走时,髋关节运动学模式更接近正常。两种条件下的穿戴和脱卸存在显著差异(P=0.046),但尽管这两种条件均通过新型MLO得到改善,但站立和坐立两种条件之间没有显著差异。与IRGO相比,新型MLO提供了更快且更独立的步态,此外,新型MLO使受试者从坐到站以及从站到坐变得更容易。

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