Biomechanical Evaluation of the Combination of Bilateral Stance-Control Knee-Ankle-Foot Orthoses and a Reciprocating Gait Orthosis in an Adult With a Spinal Cord Injury.

Reciprocating gait orthoses (RGOs) have long been used for orthotic management in patients with higher level spinal cord injuries, with one primary limitation in ambulation being attributable to the absence of knee flexion in swing phase. As a result, an individual is forced to use compensatory upper body motions to advance the legs. The authors report the use of stance-control knee-ankle-foot orthoses in combination with an isocentric RGO in a patient with a T10 spinal cord injury. A comparison is made between the scenarios of having the knees locked during the entire gait cycle to that of allowing the knees to flex freely during the swing phase, yet still be locked for stability during stance. Qualitative observation and kinematic three-dimensional gait data demonstrate that this subject ambulated with a faster, more efficient gait pattern with the stance-control feature activated. Despite having no voluntary control of his knees, this orthotic option afforded him the ability to walk safely and smoothly with both knees flexing during swing and with less upper body compensation. [ABSTRACT FROM AUTHOR]