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Objective:To compare the effect of a knee-ankle-foot orthosis (KAFO) and a paraplegic walking orthosis (WO) on the walking ability and the physiological cost index (PCI) of persons suffering from AIS A-B spinal cord injury (SCI) at the L 2 level. Methods:Thirty subjects with AIS A-B SCI at L 2, aged 20 to 45, were assigned randomly into a KAFO group ( n=15) or a WO group ( n=15). All received muscle strength, range of motion, standing, balance and weight shifting training and training in the activities of daily life. Electrotherapy and acupuncture were also administered. Both groups underwent 60 minutes of walking training 6 times per week for 12 weeks, wearing either a KAFO or a WO. Step length, gait speed, step frequency, 10-metre walk time, 6-minute walk distance and PCI were compared after 2 and 12 weeks. Results:The average step length, gait speed, step frequency, 10-metre walk time, 6-minute walk distance and PCI of both groups had improved significantly between the 2-week and 12-week evaluations, with significantly greater average improvement among the WO group at both time points.Conclusion:A WO or KAFO facilitates better walking after an AIS A-B spinal cord injury at L 2. Wearing a WO is more effective than wearing a KAFO, on average.
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@#Objective To explore the effect of comprehensive rehabilitation on patients with knee ankylosis and contracture of popliteal fossa after severe burn. Methods 35 patients with severe burn on lower limb (containing the around skin of popliteal fossa) accepted exercise therapy, hydrotherapy, occupation therapy (including pressure therapy), electrotherapy, etc. They were assessed with Functional Independence Measure (FIM), range of motion and muscle strength of knee before and after treatment. Results The scores of FIM, range of motion and muscle strength of knee improved after treatment (P<0.01). Conclusion Comprehensive rehabilitation can improve activities of daily living and function of knee after severe burn.
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Objective To explore the effects of gait training with an alternative gait orthosis (AGO) on the neurogenic bladders of patients with spinal cord injury (SCI). Method Twelve patients with complete SCI at the thoracic and lumbar level were trained for 8 weeks on motor and bladder function. After that, specific gait training with an AGO was given for another 8 weeks. American Spinal Injury Association ( ASIA ) sensation and motor function assessments were done before and after the gait training with the AGO, and bladder capacity, residual urine and urine flow rates were also assessed. Results Compared with pre-treatment there was no significant difference in average ASIA senzsation and motor scores after training, but the maximum rate of urine flow, average urine volume and single urination had significantly increased and residual urine volume had significantly decreased. Conclusions Therapeutic gait training with an AGO can improve bladder function after SCI.
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@#Objective To observe the effect of reciprocating gait orthosis on walking ability and activities of daily living (ADL) of patients with C6～T6 spinal cord injury (SCI).Methods 20 cases with C6～T6 SCI and according with type A and type B of ASIA standard received rehabilitation therapy, including training of muscle power, cardiopulmonary function, transferring mobility, ADL, bladder function, etc., before assembling the reciprocating gait orthosis, and additional gait training after fixing orthosis. The timed walking function assessment (6-min walking test and timed 10 meters walking test), gait analysis, Modified Barthel Index (MBI) and Functional Independence Measure (FMI) were used to assess pre- and post-training.Results The ADL ability of all cases improved obviously after equipping reciprocating ambulation orthosis, the walking ability also improved (P＜0.05). The mean timed 10 meters was 99.21±75.24 s, mean 6-min walk test was 41.71±29.38 m. From all patients, 14 cases achieved practicability walking ability, 6 cases achieved domestic walking ability.Conclusion The reciprocating gait orthosis combined with comprehensive rehabilitation therapy has effect on walking ability and ADL of patients with C6～T6 SCI.
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@#Objective To investigate the effect of the rehabilitative therapy on functional recovery of patients with cervical cord injury.Methods 92 cases with spinal cord injury(SCI),including cervical,thoracic and lumbar cord injury,accepted normal rehabilitation.They were assessed with the Barthel Index and Functional Independence Measure(FIM)before and after treatment.Results After rehabilitation of 60~426 d,the scores of the Barthel Index and FIM were significantly improved(P<0.001)in all the patients,but it was the worst in the cervical cord injured ones,and the best in lumbar ones(P<0.05).Conclusion Rehabilitation can promote the functional recovery of patients with cervical spinal cord injury,but it is not as effective as on the thoracic and lumbar cord injury.
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@#Objective To observe the effect of ankle-foot orthosis(AFO)on the activities of daily living(ADL)and walking ability of patients with low lumbar spinal cord injury.Methods29 cases with low lumbar spinal cord injury were trained by systematic rehabilitation.According to patients' condition,static AFO or dynamic AFO were assembled for them.All patients were evaluated with Modified Barthel Index(MBI)and Functional Independence Measure(FIM)before and after training,and the walking distances were also measured.ResultsAfter AFO dressed,the ADL scores of patients increased,especially walking ability increased significantly(P<0.05).Of 29 patients,26 cases had outdoor walking ability,3 cases had domestic walking ability.ConclusionSelecting different kinds of AFO according to condition of individual can help patients with low lumbar spinal cord injury to reconstruct their walking ability and improve ability of self-management.