The study of ambulation of paraplegics using a reciprocating gait orthosis with functional electrical stimulation: A case report

Many patients suffered from spinal cord injury with paraplegia can hardly recover to walk independently. They might need to use some special walking orthoses to support the body to walk properly. Traditionally, long leg braces (LLB) are fitted the patients for walking. Unfortunately, the results are not satisfied due to its support rather than mobile aid. In this study, we used latest reciprocating gait orthosis (RGO) and combined the use of functional electrical stimulation (FES). The combination provides larger support range and applies features of mechanical structures in walking assistant. The coordination of FES especially helps to restore the walking abilities that paralyzed patients lost. This study is to develop a walking orthosis with a FES, using a FES to stimulate specific muscles (quadriceps, hamstring) of paralyzed patients lower limbs. It can achieve the benefits of physical therapeutics; on the other hand, paralyzed patients can achieve the purpose of walking. The FES is designed with control buttons on the walking orthosis. A patient can decide and control left or right leg that he desires to move to walk, and consequently accomplishes the purposes of walking control and speed via the control buttons. After the completion of the development and several practical tests of the new walking orthosis. A 25- years-old female paralyzed patient (L1 complete spinal cord injury) separately used traditional LLB, RGO, and RGO with FES to proceed with the training of walking rehabilitation and clinical assessment. After comparisons with heart rate difference (HR difference), mean blood pressure difference (MBP difference), walking speed, length of steps, number of steps and oxygen consumption before and after walking, the results show that usage of RGO and RGO with FES are both better than LLB. But, the differences between RGO and RGO with FES in HR difference, MBP difference, and walking speed are not significant, due to that the reaction of patient's right leg to electrical stimulation is relatively lower. In general, RGO can help the patient to achieve quicker and more independent walking; while the combination of RGO and FES can raise the effectiveness of RGO for more mobile aid. These two walking orthoses are better than traditional LLB, they provide patients suffered from paraplegia with better choices.