Bernardi M, Canale I, Castellano V, Di Filippo L, Felici F, Marchetti M
Istituto di Fisiologia Umana, Facoltà di Medicina, Università di Roma La Sapienza, Italy.
Paraplegia. 1995 Jul;33(7):409-15. doi: 10.1038/sc.1995.91.
A number of orthoses have been designed to restore stance and walking in paraplegic subjects. Among them, the reciprocating gait orthosis (RGO) appears to be one which is most widely adopted. The great energetic cost of orthotically aided walking is the main factor limiting the walking capability of paraplegic subjects. The purpose of the present research was to give a complete biomechanical evaluation of RGO locomotion in order to provide data that can be used for further improvements of the orthosis. From the whole body kinematics the mechanical work done to move the orthosis was estimated; by measuring the actual metabolic cost of RGO locomotion the efficiency was evaluated as the ratio between mechanical work and energy expenditure. It is found that RGO locomotion is a very demanding task in terms both of energy expenditure and of the mechanical work required. Furthermore, it is evident that the major determinant of this poor efficiency of RGO locomotion is the enormous amount of work required to move the orthosis which, in turn, reflects its poor mechanical characteristics. To accomplish the demand of real mobility, devices for transferring work from the upper to the lower portion of the body must be substantially improved. This technical aspect must be parelleled by suitable training programmes especially designed to improve the aerobic power of paraplegic subjects and their body composition (ie less fat and more muscle).
已经设计了多种矫形器来恢复截瘫患者的站立和行走能力。其中，往复式步态矫形器（RGO）似乎是应用最为广泛的一种。矫形辅助行走所消耗的巨大能量是限制截瘫患者行走能力的主要因素。本研究的目的是对RGO行走进行全面的生物力学评估，以便提供可用于进一步改进该矫形器的数据。通过全身运动学来估算移动矫形器所做的机械功；通过测量RGO行走的实际代谢成本，将效率评估为机械功与能量消耗的比值。研究发现，RGO行走在能量消耗和所需机械功方面都是一项要求很高的任务。此外，很明显，RGO行走效率低下的主要决定因素是移动矫形器所需的大量功，这反过来又反映了其不良的机械特性。为了满足实际移动的需求，必须大幅改进将功从身体上部传递到下部的装置。这一技术方面必须辅以专门设计的合适训练计划，以提高截瘫患者的有氧能力及其身体成分（即减少脂肪、增加肌肉）。
