Functional outcomes attained by T9-12 paraplegic patients with the walkabout and the isocentric reciprocal gait orthoses

Abstract

Objective: To compare the functional outcomes attained by persons with paraplegia using the Walkabout Orthosis (WO) and the Isocentric Reciprocal Gait Orthosis (IRGO). Design: A randomized crossover design. Patients: Ten subjects with complete lesions between T9-T12. Interventions: Over two 8-week periods, subjects were taught to use each orthosis in conjunction with elbow crutches. Main Outcome Measures: After each 8-week training period, subjects were assessed on their ability to perform five different sets of key skills associated with functional ambulation. Results: There were no differences between orthoses in the ability of subjects to don and doff the orthoses, get up and down stairs and curbs, or walk on a flat surface. Subjects required significantly more assistance when using the WO to walk over inclined surfaces (median IRGO = “independent,” median WO = “minimal assistance”; p = .03) but less assistance when using the WO to get from sitting to standing and standing to sitting (median IRGO = “moderate assistance,” median WO = “minimal assistance”; p = .03). In addition, subjects walked significantly faster with the IRGO both on the flat (mean IRGO = .34m/sec ± .18, mean WO = .14m/sec ± .12; p = .002) and on inclined surfaces. Conclusions: Although it is easier to stand up and sit down with the WO, the IRGO facilitated a faster and more independent gait. Neither orthosis enabled subjects to be fully independent in the key skills necessary for functional ambulation after 8 weeks of training.