Journal of Clinical Physiotherapy Research

Abstract

Introduction: Walking is a complex activity that depends on the coordination between muscles and joints, a capability that is significantly impaired in individuals with spinal cord injuries (SCI). To enhance gait efficiency, reduce energy expenditure, and promote independence among patients with SCI, Medial Linkage Orthoses (MLOs) have been developed. In contrast, conventional orthotic solutions like Knee-Ankle-Foot Orthoses (KAFOs) and Hip-Knee-Ankle-Foot Orthoses (HKAFOs) often lead to high energy costs and low user satisfaction. Material and Methods: This review investigated the evolution and effectiveness of various orthotic devices, with a particular focus on MLOs, including the Walkabout and Prime Walk. A thorough literature search was conducted across databases covering the period from 1960 to 2024 using relevant keywords. 23 articles met the criteria for data extraction, guided by a standardized protocol. Results: The review’s findings emphasize the influence of spinal cord Orthoses on gait, energy consumption, and overall user satisfaction. The development of orthotic devices, particularly MLOs, marks a notable advancement in treating gait dysfunctions associated with SCI. Evidence suggests that MLOs, such as Walkabout and Prime Walk, offer significant advantages over traditional KAFOs and HKAFOs in terms of biomechanics, energy efficiency, and user satisfaction. Specifically, innovations like Ahmadi's model demonstrate improved biomechanical alignment and reduced energy expenditure, making walking more feasible for patients with SCI. Conclusion: Ultimately, the implementation of MLOs could greatly enhance independence and improve the quality of life for individuals with SCI. Further research is essential to optimize the designs of these orthotic devices and to investigate their long-term effects on functional outcomes within SCI populations.