Medical Journal of the Islamic Republic Of Iran

en Assessment of the Effect of Improved Medial Linkage Reciprocating Orthosis Compared to Isocentric Orthosis on the Motor Function in Spinal Cord Injury Patients Rehabilitation Rehabilitation Original Research Original Research Background: Spinal cord injuries (SCI) result in profound mobility impairments, particularly the inability to walk. Traditional orthotic devices, while aiding mobility, often lead to high energy expenditure and discomfort. This study aimed to develop a novel orthosis that enhances comfort, improves movement parameters, and reduces energy consumption by incorporating medial linkage joints and reciprocal mechanisms into the existing Medial Linkage Reciprocating Gait Orthosis (MLRGO). The effectiveness of this new device was evaluated against both the Isocentric Reciprocating Gait Orthosis (IRGO) and conventional Knee-Ankle-Foot Orthoses (KAFOs) in a case study with three participants.    Methods: This case study involved three patients with thoracic SCI, selected through convenience sampling. The new MLRGO was designed in the initial phase, followed by a comparative analysis involving the new MLRGO, IRGO, and KAFOs. Parameters assessed included average step length, walking speed, cadence, physiological cost index (PCI), static balance, and the time required for donning and doffing the orthoses, using standardized assessment tests. Repeated measures ANOVA with Bonferroni correction was used to compare group means, with a significance level of P value< 0.05.    Results: The new MLRGO significantly enhanced walking speed (P=0.037 vs. IRGO, P=0.006 vs. KAFOs), distance (P=0.036 vs. KAFOs), average step length (P=0.084 vs. KAFOs), and cadence (P=0.098 vs. KAFOs) compared to both the IRGO and KAFOs. Furthermore, it demonstrated superior energy efficiency relative to KAFOs (P=0.050), although no significant differences were found when compared to the IRGO. The new MLRGO also reduced donning (P=0.008 vs. IRGO) and doffing times (P=0.008 vs. IRGO), achieving performance levels comparable to KAFOs.    Conclusion: The findings suggest that the new MLRGO facilitates a more natural and efficient walking pattern in patients with SCI compared to the IRGO and KAFOs. However, due to the small sample size, further studies are needed to confirm its efficacy as a promising alternative for rehabilitation in individuals with lower limb paralysis.   Orthotic Devices, Spinal Cord Injuries, Gait, Motor Function, Energy Efficiency, Rehabilitation 322 327 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-4450-5&slc_lang=en&sid=1 Abolfazl Rajabi Moghadam Rajabi.arm@gmail.com 200319475328460097387 200319475328460097387 No Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Aliyeh Daryabor Aliyehdaryabor@gmail.com 200319475328460097388 200319475328460097388 No Physiotherapy Research Center, Department of Orthotics and Prosthetics, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mokhtar Arazpour m.arazpour@gmail.com 200319475328460097389 200319475328460097389 No Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Behnam Hajiaghaei bhajiaghaei@yahoo.com 200319475328460097390 200319475328460097390 No Rehabilitation Research Center, Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran Taher Babaee taher.to3@gmail.com 200319475328460097391 200319475328460097391 Yes Rehabilitation Research Center, Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran