Effect of medially linked and unlinked knee immobilizer on paraplegic gait performance

Randomized clinical trial.

To evaluate the effect of attaching a medial linkage single axis hip joint to knee immobilizer on gait outcomes of paraplegic individuals. Knee immobilizers provide no control at the hips. Medially linking the two Knee Immobilizers serves to restrict mediolateral and rotational movements at the hip which could provide better stability and ambulation.

Rehabilitation department, Indian Spinal Injuries Centre, New Delhi.

29 subjects with thoracic (T8-T12) spinal cord injury.

knee Immobilizer, Paper walkway, Ink, Measuring tape, Stop watch.

Two groups A and B were formed. Group A (control group) underwent balance and gait training with unlinked Knee Immobilizer and Group B (Experimental Group) underwent same training with linked Knee Immobilizers. Both groups were given the training for 4 weeks within parallel bars for 40 min. each day for 5 days/week. Gait analysis was performed after the gait training in both the groups.

Walking velocity, Cadence, Stride length & Foot angle were recorded using Ink-footprint record and ambulation time.

Independent sample t-test was used to analyze the difference between gait outcomes. Correlation co-efficient analysis was done to find out the relationship between gait parameters.

Significant differences existed in all gait parameters. Experimental group had increased velocity and cadence but reduced stride length and foot angle than control group (p < 0.05 for each parameter). Velocity and cadence were highly correlated with one another (r > 0.76).

Medially linked Knee Immobilizer has better gait outcomes as compared to linked Knee Immobilizer in Paraplegic individuals. However, the Energy factor should also be considered.