**6. Orthotic gait training of SCI subjects with the mechanical orthoses**

There were different types of mechanical orthoses such as hip-knee-ankle-foot orthosis, reciprocating gait orthosis (RGO) (**Figure 6**), hip guidance orthosis, and medial linkage orthoses (e.g. walkabout orthosis (WO), Primewalk orthosis (**Figure 7**)) to provide standing and walking in subjects with SCI [30]. Several studies evaluated this type of orthoses on walking ability in these subjects [30]. Based on the evaluation of the energy expenditure, Harvey et al. demonstrated that energy consumption of walking with the WO were greater than walking with the isocentric reciprocating gait orthosis (IRGO) in SCI subjects with T9–12 paraplegia [33]. In addition in another study, Harvey et al*.* demonstrated that stand up and sit down with WO was easier than IRGO, but IRGO provided faster and more independent ambulation [34]. In comparison of the attitude of subjects with SCI when using WO and the IRGO, Harvey et al. reported few

> subjects used orthosis more than once every 2 weeks, and SCI individuals were primarily wearing the orthoses for therapeutic aims [35]. To evaluate the influence of Primewalk orthosis and walkabout orthosis in improving the walking performance in subjects with SCI, Ongio et al. demonstrated the Primewalk orthosis had better effect in walking efficiency than that of the

Role of Gait Training in Recovery of Standing and Walking in Subjects with Spinal Cord Injury

http://dx.doi.org/10.5772/intechopen.71312

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Training time announced different in this field between 2 until 12 weeks. Longitudinal training program demonstrated the better results on the improvement of walking parameters. The maximum rate of the speed of walking reported from 0.13 to 0.63 m/s, which is 13–57% of the optimal speed (1.1 m/s) required for successful community ambulation [37]. Home or indoor mobility for exercise, upright posture, and standing reported final benefits of orthotics gait

The successful orthotic gait rehabilitation in SCI subjects related to the several factors included well-motivated, with complete level of injury at T9 or below, incomplete level of injury, postural control, and [39–41] good upper extremity strength, as well as less spasticity and low level contractures [42], reduced thoracolumbar mobility, back pain, or any musculoskeletal problems that influenced standing upright [33, 43]. Orthotic gait rehabilitation can be influenced by the acceptance of orthoses. In other words, acceptance of orthoses may be influenced by donning and doffing time, the best time for donning and doffing of orthosis should be less than 5 minutes [31].

**7. Orthotic gait training of SCI subjects with powered gait orthoses**

Providing gait training in different environments such as clinic, home, or community announced as the main benefit of wearing powered gait orthosis [3]. Only limited PGOs are currently commercially available to the public and therefore would be able to be used

Walkabout orthosis [36].

**Figure 7.** Walkabout orthosis and Primewalk orthosis.

rehabilitation [38, 39].

**Figure 6.** Isocentric reciprocating gait orthosis [32].

Role of Gait Training in Recovery of Standing and Walking in Subjects with Spinal Cord Injury http://dx.doi.org/10.5772/intechopen.71312 113

**Figure 7.** Walkabout orthosis and Primewalk orthosis.

**Figure 6.** Isocentric reciprocating gait orthosis [32].

were used to low incomplete level of spinal cord injury and high complete or incomplete level of injury [31]. In general concept, all orthoses were used with walking aid for ambulation. Several factors influenced the providing walking ability via orthoses in the SCI subjects,

**6. Orthotic gait training of SCI subjects with the mechanical orthoses**

There were different types of mechanical orthoses such as hip-knee-ankle-foot orthosis, reciprocating gait orthosis (RGO) (**Figure 6**), hip guidance orthosis, and medial linkage orthoses (e.g. walkabout orthosis (WO), Primewalk orthosis (**Figure 7**)) to provide standing and walking in subjects with SCI [30]. Several studies evaluated this type of orthoses on walking ability in these subjects [30]. Based on the evaluation of the energy expenditure, Harvey et al. demonstrated that energy consumption of walking with the WO were greater than walking with the isocentric reciprocating gait orthosis (IRGO) in SCI subjects with T9–12 paraplegia [33]. In addition in another study, Harvey et al*.* demonstrated that stand up and sit down with WO was easier than IRGO, but IRGO provided faster and more independent ambulation [34]. In comparison of the attitude of subjects with SCI when using WO and the IRGO, Harvey et al. reported few

which gait training is the important of them [32].

112 Essentials of Spinal Cord Injury Medicine

subjects used orthosis more than once every 2 weeks, and SCI individuals were primarily wearing the orthoses for therapeutic aims [35]. To evaluate the influence of Primewalk orthosis and walkabout orthosis in improving the walking performance in subjects with SCI, Ongio et al. demonstrated the Primewalk orthosis had better effect in walking efficiency than that of the Walkabout orthosis [36].

Training time announced different in this field between 2 until 12 weeks. Longitudinal training program demonstrated the better results on the improvement of walking parameters. The maximum rate of the speed of walking reported from 0.13 to 0.63 m/s, which is 13–57% of the optimal speed (1.1 m/s) required for successful community ambulation [37]. Home or indoor mobility for exercise, upright posture, and standing reported final benefits of orthotics gait rehabilitation [38, 39].

The successful orthotic gait rehabilitation in SCI subjects related to the several factors included well-motivated, with complete level of injury at T9 or below, incomplete level of injury, postural control, and [39–41] good upper extremity strength, as well as less spasticity and low level contractures [42], reduced thoracolumbar mobility, back pain, or any musculoskeletal problems that influenced standing upright [33, 43]. Orthotic gait rehabilitation can be influenced by the acceptance of orthoses. In other words, acceptance of orthoses may be influenced by donning and doffing time, the best time for donning and doffing of orthosis should be less than 5 minutes [31].
