title: The effect of trunk extension on physiological cost index in spinal cord injury patients when using the advanced reciprocating gait orthosis: A pilot study.
abstract: BACKGROUND
  People with spinal cord injury walk with a flexed trunk when using reciprocating gait orthoses for walking. Reduction in trunk flexion during ambulation has been shown to improve gait parameters for reciprocating gait orthosis users.
  
  
  OBJECTIVE
  The aim of this study was to investigate the effect on energy expenditure when spinal cord injury patients ambulate with an advanced reciprocating gait orthosis while wearing a thoracolumbosacral orthosis to provide trunk extension.
  
  
  METHODS
  Quasi experimental study.
  
  
  METHODS
  Four patients with spinal cord injury were fitted with an advanced reciprocating gait orthosis after completing a specific gait training program. Patients walked along a flat walkway using the advanced reciprocating gait orthosis as a control condition and also while additionally wearing a thoracolumbosacral orthosis at their self-selected walking speed. A stopwatch and a polar heart rate monitor were used to measure walking speed and heart rate.
  
  
  RESULTS
  Walking speed, the distance walked, and the physiological cost index all improved when walking with the advanced reciprocating gait orthosis/thoracolumbosacral orthosis test condition compared to walking with no thoracolumbosacral orthosis in situ.
  
  
  CONCLUSIONS
  Spinal cord injury patients can improve their walking speed, walking distance, and physiological cost index when wearing a thoracolumbosacral orthosis in conjunction with an advanced reciprocating gait orthosis, which may be attributed to the trunk extension provided by the thoracolumbosacral orthosis.
  
  
  CONCLUSIONS
  It is concluded that wearing thoracolumbosacral orthosis in association with an advanced reciprocating gait orthosis could be an effective alternative in rehabilitation for thoracic level of paraplegic patients to promote their health and well-being.
authors.affiliation: Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran.|Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
authors.forename: Mokhtar
authors.initials: M
authors.lastname: Arazpour
authors.affiliation: Loghman Hakim hospital, Shahid Beheshti University of Medical Sciences, Department of Neurosurgery, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Samadian
authors.affiliation: Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Bahramizadeh
authors.affiliation: Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran.
authors.forename: Monireh
authors.initials: M
authors.lastname: Ahmadi Bani
authors.affiliation: Department of Occupational Therapy, Mazandaran University of Medical Sciences, Sari, Islamic Republic of Iran gharib_masoud@yahoo.com.
authors.forename: Masoud
authors.initials: M
authors.lastname: Gharib
authors.affiliation: Department of Occupational therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
authors.forename: Seyyed Ali
authors.initials: SA
authors.lastname: Hosseini
authors.affiliation: IHSCR, Faculty of Health & Social Care, University of Salford, Manchester, Salford, UK.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Hutchins
authors.affiliation: Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran.
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Mardani
mesh_terms: D000328:Adult; D004734:Energy Metabolism / Q000502:physiology*; D004867:Equipment Design; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D009989:Orthotic Devices; D010865:Pilot Projects; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000534:rehabilitation; D013904:Thoracic Vertebrae; D060726:Torso; D055815:Young Adult
keywords: Paraplegia; advanced reciprocating gait orthosis; energy consumption; physiological cost index; spinal cord injury; walking