CLINICAL-EXPERIENCE WITH A NEW HIP-KNIFE-ANKLE-FOOT ORTHOTIC SYSTEM USING A MEDIAL SINGLE HIP-JOINT FOR PARAPLEGIC STANDING AND WALKING

The Walkabout(R) is a new hip-knee-ankle-foot orthotic (HKAFO) system with a medial single hip joint (MSH-KAFO) invented by S. McKay in 1992 . Compared with other HKAFO systems, the hip joint part is compact and removable, so it has distinguishable, real merits: ease in donning an d doffing the device, compatibility with a wheelchair, and cosmesis. W e clinically tested five patients, paraplegic because of spinal cord i njury, using the MSH-KAFO system. All were males, aged 26-36 yr old. T heir functional levels were L-1 (2 cases), T-10 (2 cases), and T-5 (1 case). All patients could stand stably without crutches and walk in pa rallel bars immediately the first time they wore the braces. After a f ew hours of crutch-walking exercises, all could walk independently wit h Lofstrand crutches. Their walking velocities ranged from 10 to 37.5 (mean, 19.9) m/min at the follow-up points (mean, 7.1 mo). With four c ases, we measured oxygen uptake for predictions of energy consumption. At comfortable walking predicted energy consumptions were from 1.31 t o 3.89 (mean, 2.75) METs. Compared with the data in literature, these seemed to be at the same level with normal walking and lower than the KAFOs walking level. Our results suggest that MSH-KAFO is a very conve nient standing and walking device for paraplegics and is compatible wi th wheelchair use.