Gait evaluation of the advanced reciprocating gait orthosis with solid versus dorsi flexion assist ankle foot orthoses in paraplegic patients

Background: Mechanical orthoses are used for standing and walking after neurological injury. Most orthoses such as the advanced reciprocating gait orthosis typically use solid ankle-foot orthoses. Objectives: The goal of this study was to test the effects of ankle dorsiflexion assistance in patients with spinal cord injury when ambulating with an advanced reciprocating gait orthosis compared to walking with fixed ankles. Study Design: Quasi-experimental. Methods: Four patients with spinal cord injury were fitted with an advanced reciprocating gait orthosis equipped with solid and dorsiflexion assist-type ankle-foot orthoses and walked at their self-selected speed. Joint angles and spatial-temporal parameters were measured and analyzed. Results: The mean walking speed and stride length were both significantly increased along with cadence by the volunteer subjects when ambulating using the advanced reciprocating gait orthosis fitted with dorsiflexion assist ankle-foot orthoses compared to the advanced reciprocating gait orthosis with solid ankle-foot orthoses. The mean ankle joint ranges of motion were significantly increased when walking with the advanced reciprocating gait orthosis with dorsiflexion assist ankle-foot orthoses compared to when using the advanced reciprocating gait orthosis with the solid ankle-foot orthoses. Knee joint ranges of motion were reduced, and hip joint ranges of motion were increased but not significantly. Conclusion: The advanced reciprocating gait orthosis fitted with the dorsiflexion assist ankle-foot orthoses had the effect of improving gait parameters when compared to the advanced reciprocating gait orthosis with solid ankle-foot orthoses.