Lower extremity orthoses in spinal cord injury [Medulla spinalis yaralanmalarinda alt ekstremite ortezleri]

Abstract

Bracing systems, in addition to walking, can improve bone density, urinary drainage, bowel function, respiratory mechanics, spasticity, contractures and psychological health. Walking is one of the most important functions missed by the paraplegics. Paraplegics with normal upper limbs can walk with orthoses. Tetraplegics want to walk with orthoses but this is not always realistic. In selection of orthoses for spinal cord injury (SCI) patient, a number of factors must be considered, such as the type and the level of injury, range of motion of joints, occupation, recreational goals, motivation, fitness level, and residual muscle strengths. The type and level of injury, as well as the strengths of the remaining muscles are the primary indicators of the type of gait aids and orthotic intervention required. There are four bracing systems in widespread use to restore the mobility following SCI: Ankle-foot orthosis, knee-ankle-foot orthosis, reciprocating gait orthosis, and hip guidance orthosis. In this article, selection and usage principles of orthosis, relationship between the spinal injury level and the type of orthosis chosen, and some characteristics of certain orthoses in patients with SCI are discussed.