The efficacy of powered orthoses on walking in persons with paraplegia

Background: Powered orthoses are a new generation of assistive devices for people with spinal cord injury, which are designed to induce motion to paralyzed lower limb joints using external power via electric motors or pneumatic or hydraulic actuators. Objective: Powered gait orthoses provide activated movement of lower limb joints to limit the forces applied through the upper limb joints and trunk muscles during ambulation due to the need to use an external walking aid, while simultaneously improving the kinetics and kinematics of walking in subjects with spinal cord injury. This article reviews their walking efficacy when used by people with paraplegia. Study design: Literature review. Method: A literature search was performed in ISI Web of Knowledge, PubMed, Google Scholar, ScienceDirect, and Scopus databases. Results: Efficacy was demonstrated in producing activated motion of lower limb joints. Powered gait orthoses have a beneficial effect on the kinetics, kinematics, and temporal-spatial parameters of gait, but their effect on muscle activity in individuals with spinal cord injury is still unclear. Conclusions: Further research is needed regarding the design and construction of powered gait orthoses using significant power application to the ankle joints and their effect on lower limb muscle activity and gait patterns in spinal cord injury subjects. Clinical relevance Powered orthoses is a new generation of orthotic intervention that could potentially be significant in assisting in improving the walking parameters and energy consumption of spinal cord injury subjects.