At 9 months post injury he remains a therapeutic ambulator. His right knee frequently buckles, and the ankle frequently inverts. A right leg knee ankle foot orthosis is considered.
What evidence is there regarding the efficiency of brace/orthotic devices for upright support and mobility?
1. There is limited evidence that bracing (figure 5a and 5b) alone enables significant gains in functional ambulation for people with higher level complete paraplegia. The benefits of bracing appear largely restricted to general health and well-being associated with the practice of standing and the ability to ambulate short-distances in the home or indoor settings. The benefits of bracing-alone on functional ambulation are primarily shown for people with low complete paraplegia or incomplete spinal lesions.
2. There is limited evidence that a combined approach of bracing and FES results in additional benefit to functional ambulation in higher paraplegic patients with complete SCI although long-term feasibility for this population is not proven and also is likely restricted to general health and well-being associated with the practice of standing and the ability to ambulate short-distances in the home or indoor settings.
For more information please see: Braces and Orthotic Devices.
Figure 5a. Modular ankle-foot orthosis.
Figure 5b. Knee ankle foot orthosis.