title: The influence of orthosis options on walking parameters in spinal cord-injured patients: a literature review.
abstract: OBJECTIVE
  Orthoses for various joints sections are considered to greatly influence the gait function and energy expenditure in spinal cord-injured (SCI) patients. The aim of this review was to determine the influence of orthoses characteristics and options on the improvement of walking in patients with SCI.
  
  
  METHODS
  A search was performed using the Population Intervention Comparison Outcome (PICO) method, based on selected keywords; studies were identified electronically in the Science Direct, Google Scholar, Scopus, Web of Knowledge and PubMed databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used to report the results. Assessment of the quality of all articles was performed based on the Physiotherapy Evidence Database (PEDro scale).
  
  
  RESULTS
  Twelve studies evaluated the effects of different hip joint options on walking parameters and energy expenditure. Five studies investigated the role of knee joint options on gait parameters and compensatory trunk motion. Only five studies analyzed modified ankle joints on gait parameters in SCI patients. Nine studies analyzed gait parameters in SCI patients as powered orthoses and exoskeleton. These studies had a low level of evidence according to the PEDro score (2/10).
  
  
  CONCLUSIONS
  The various joint types of orthoses appear to be critical in the improvement of walking in patients with SCI. In particular, 'user friendly' orthoses that support the related structure such as the hip joint with a reciprocating mechanism, activated knee joint and movable ankle joint with dorsiflexion assist enable SCI patients to optimize their walking pattern when wearing an orthoses system.
authors: Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
authors: M
authors: M
authors: Arazpour
authors: Department of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors: M
authors: M
authors: Samadian
authors: Department of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors: K
authors: K
authors: Ebrahimzadeh
authors: Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
authors: M
authors: M
authors: Ahmadi Bani
authors: Centre for Rehabilitation and Human Performance Research, Faculty of Health and Social Care, University of Salford, Salford, UK.
authors: S W
authors: SW
authors: Hutchins
mesh_terms: D016208:Databases, Factual / Q000706:statistics & numerical data; D020233:Gait Disorders, Neurologic / Q000209:etiology* / Q000628:therapy*; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D009989:Orthotic Devices; D013119:Spinal Cord Injuries / Q000150:complications*; D016138:Walking / Q000502:physiology*