The Effect of Spatial and Temporal Parameters on The Energy Expenditure of Orthotic Gait of Paraplegics

Objectives: Although for those spinal cord injury (SCI) patients with paralysis of the legs but not at arms, the primary means of mobility post injury is the manual wheelchair, there are many physiological and psychological advantages to standing and walking, such as improvement in respiratory function, lower limb weight bearing and preventing osteoporosis, pressure sores prevention etc. High metabolic energy expenditure of orthotic ambulation in contrast with the manual wheelchair is the most limitation of the orthotic gait currency for SCI patients. Methods: In the present study, the effect of the spatial and temporal parameters on the mechanical energy expenditure of the paraplegic locomotion was investigated in search for a modified gait pattern which provides lower energy Expenditure. A 3D four segment 6-DOF model of the paraplegic locomotion was developed based on the data acquired from an experimental study on a single spine cord injury subject. A Response Surface Methodology (RSM) was then performed to determine the impact of the kinematical parameters on the resulting the joint torques. Results: According to the RSM analysis, the whole body forward inclination around the stance leg has been recognized as the most effective kinematics parameter on the total muscular effort as an index of energy expenditure during the paraplegic gait. Conclusion: It was concluded that with a reduction on the step length accompanied with cadence increasing in a modified gait pattern, the paraplegic individuals are expected to achieve improved energy expenditure.