What Are the Next Steps in Designing an Orthosis for Paraplegic Subjects?

Background: Over the years, various types of orthoses have been designed to assist subjects with spinal cord injury (SCI) to stand and walk. However, the functional performance of the orthoses has not been adequate, that is, patients experience stability problems, consume excessive energy during ambulation, and generally require assistance in donning and doffing the devices. This research is aimed at categorizing the available orthoses designed specifically for SCI patients and to compare the available orthoses according to the energy consumption, stability analysis, and gait parameters. Methods: An electronic search was done in PubMed, Embase, and ISI Web of Knowledge databases to extract data related to 1960 – 2010. The available orthoses were characterized based on the level of stabilization they provided and the source of power used. The orthoses were compared based on the stability, energy consumption, and gait performance parameters, according to the results of various studies collected from the literature review. Results: Among various orthoses designed for paraplegic subjects, the mechanical orthoses seemed to have a better performance. Moreover, donning and doffing of the mechanical orthosis was easier for the subjects. Conclusion: Although the HGO has better functional performance than other available orthoses, the subjects are more willing to use the RGO. The new design of orthoses must allow easy donning and doffing by the users, have enough stability during walking and standing, and enable the patients to change the alignment of the orthosis to suit their needs.