Driven gait orthosis for improvement of locomotor training in paraplegic patients

Design: Single cases. Objective: To compare the effects of manually assisted locomotor training in paraplegic patients with the automated training by a driven gait orthosis, Setting: ParaCare, University Hospital Balgrist in Zurich, Switzerland. Methods: Treadmill training with manual assistance and by a driven gait orthosis was applied to two spinal cord injured patients, The first patient had an incomplete lesion at C3, the second a complete lesion at C5, They were selected by convenience sample. The EMG activity of the leg muscles rectus femoris, biceps femoris. gastrocnemius medials (GM) and tibialis anterior (TA) was visually compared for the two training methods. GM and TA activity was also quantified by calculating the variation ratio between the EMG of the patients and a set of healthy subjects. Results: No significant difference between the two training methods was found according to the leg muscle EMG activity. Conclusion: Neuronal centers in the spinal cord become activated in a similar way by the manually assisted and the automated locomotor training, With the driven gait orthosis training sessions can be prolonged and workload of therapists can be reduced, and therefore, the automated training represents an alternative to the conventional therapy.