Walking with a hybrid orthosis system

The purpose of this case study was to determine the functional effectiveness of the hybrid orthosis system (HOS) for sit-to-stand and walking compared with the reciprocal gait orthosis (RGO) alone in a subject with significant orthopedic abnormalities.

A subject with complete T7 paraplegia and a 13 cm leg length discrepancy was implanted with 14 intramuscular electrodes and fitted with a custom isocentric RGO. The subject was instructed in the use of the HOS and a two wheeled walker in the home and community settings.

Using the Functional Independence Measure (FIM), and the Borg exertion scale the subject's level of independence and his perceived exertion was determined as well as the safety and efficacy of system use in the community.

Results show that the HOS provided safe, independent ambulation with a two wheeled walker and met established criteria for limited community use. Walking in the RGO alone was feasible, however, the addition of functional electrical stimulation (FES) allowed this subject to walk farther and with less perceived exertion.

This case study suggests that a hybrid orthosis system can be an effective clinical option for individuals with significant orthopedic complications that might otherwise contra-indicate the prescription of either conventional braces or FES alone.