Lotta S, Fiocchi A, Giovannini R, Silvestrin R, Tesio L, Raschi A, Macchia L, Chiapatti V, Zambelli M, Tosi C
Centro di Recupero e Rieducazione Funzionale G. Verdi, Piacenza, Italy.
Paraplegia. 1994 Sep;32(9):608-15. doi: 10.1038/sc.1994.96.
Twenty-eight patients with complete T3-12 traumatic paraplegia were fitted with hip guidance orthosis (HGO, four cases), reciprocating gait orthosis (RGO, 13 cases) or advanced reciprocating gait orthosis (ARGO, 11 cases). Patients were enrolled for 2 months-6 years (median 5 months) in six Italian rehabilitation centres engaged in a common prospective protocol, including a 6 month follow up. After 12-84 (median 20) rehabilitation sessions over a 3-16 week (median 7) period of specific training all of the patients could perform don-doff manoeuvres autonomously in 2.5-15 min (median 6.4), and could walk at least 30 m with a walker (15 cases) or forearm crutches (13 cases) at 10-50 cm/s (median 16.6). HGO patients tended to walk more slowly than the others. None of them could walk upstairs, while three out of 13 RGO patients and seven out of 11 ARGO patients could. Six months later, 21 patients still used the orthosis for 0.5-3 h daily (median 2). Only four patients used the orthosis to walk outdoors. As a median they could still attain the speed recorded at discharge. Six patients had decided to abandon the device, while one was wheelchair bound due to a recent spinal intervention. Neither clinical, demographic or locomotor variables, nor centre and type of orthosis appeared to be predictive of abandonment of the device. During either the training or the follow up periods, six out of 13 RGO and seven out of 11 ARGO had to be repaired by the orthotist 1-10 times (median 3). Thus, in our sample of paraplegics, walking with these orthoses appeared to be a promising form of exercise rather than an alternative to wheelchair locomotion.
28例T3 - 12完全性创伤性截瘫患者装配了髋部引导矫形器（HGO，4例）、往复式步态矫形器（RGO，13例）或先进往复式步态矫形器（ARGO，11例）。患者在6家参与共同前瞻性方案的意大利康复中心入组2个月至6年（中位时间5个月），包括6个月的随访。在3至16周（中位时间7周）的特定训练期间进行12至84次（中位时间20次）康复治疗后，所有患者都能在2.5至15分钟（中位时间6.4分钟）内自主完成穿脱动作，并且能够使用助行器（15例）或前臂拐杖（13例）以10至50厘米/秒（中位速度16.6厘米/秒）至少行走30米。HGO患者行走速度往往比其他患者慢。他们中没有人能上楼梯，而13例RGO患者中有3例、11例ARGO患者中有7例可以。6个月后，21例患者仍每天使用矫形器0.5至3小时（中位时间2小时）。只有4例患者使用矫形器在户外行走。作为中位数，他们仍能达到出院时记录的速度。6例患者决定放弃该装置，而1例因近期脊柱干预而只能依赖轮椅。临床、人口统计学或运动变量，以及矫形器的中心和类型似乎都不能预测是否会放弃该装置。在训练或随访期间，13例RGO患者中有6例、11例ARGO患者中有7例需要矫形师修理1至10次（中位时间3次）。因此，在我们的截瘫患者样本中，使用这些矫形器行走似乎是一种有前景的锻炼方式，而不是轮椅移动的替代方式。
