Comparison of the Efficacy of Two Different Medial Linkage Mechanisms in Knee-Ankle-Foot Orthoses on Walking Ability in Subjects with Spinal Cord Injury

Introduction: This study evaluated the efficacy of two differentmedial linkage mechanisms (slidingmechanism[SM] and medial linkage mechanism associated with reciprocating gaitmotion (MLRGM), used within otherwise identical knee-ankle-foot orthoses (KAFOs) on patients with spinal cord injury (SCI). Methods: Three volunteer subjects with SCI were fitted with a KAFO equipped with 1) an SMand 2) a medial linkage mechanism (MLRGM). Subjects walked at their self-selected speed along a flat walkway to enable a comparison of walking speed, endurance, and the resulting physiological cost index to be performed. Results: The use of a KAFO fitted with the MLRGM resulted in improvements in walking speed, distance walked, and energy costs when compared with the more standard SM. However, the time required to don the KAFO increased with use of the MLRGM, but doffing time was approximately equal for both types. Conclusions: This study demonstrated that the use of a KAFO with an MLRGM could provide significant benefits for patients with SCI when compared with a KAFO with a standard SM.