Standing performance of persons with paraplegia

Area of Science:

• Biomechanics
• Rehabilitation Engineering
• Neuroscience

Background:

• Individuals with paraplegia often experience impaired postural control.
• Knee-ankle-foot orthoses (KAFOs) are assistive devices used to improve standing ability.
• Assessing the effectiveness of orthotic devices is crucial for mobility restoration.

Purpose of the Study:

• To evaluate the standing stability of individuals with paraplegia using KAFOs.
• To compare the postural stability of KAFO users with neurologically healthy individuals.
• To investigate the effects of unlocked KAFO ankles and quadriceps functional neuromuscular stimulation (FNS) on stability.

Main Methods:

• Center-of-force (CoF) monitoring platform used to measure sway path, mean amplitude, and mean frequency.
• Comparison between four individuals with paraplegia using KAFOs and ten neurologically healthy subjects.
• Testing under various conditions: quiet standing (eyes open/closed), hands on/off parallel bars, unlocked KAFO ankles, and quadriceps FNS.

Main Results:

• Paraplegic individuals using KAFOs demonstrated comparable postural stability to controls with hands on parallel bars (eyes open/closed).
• Visual information was significantly more critical for maintaining balance in the paraplegic group.
• Unlocking KAFO ankles increased sway path and mean frequency, while quadriceps FNS resulted in slightly less stability than KAFOs.

Conclusions:

• KAFOs offer reasonable postural stability for individuals with paraplegia, though not ideal for all functional needs.
• The importance of visual input for balance in paraplegic individuals using KAFOs is highlighted.
• Future orthotic alternatives must demonstrate comparable or superior stability to KAFOs to be considered viable options.