Restoration of gait with hybrid FES using knee unlocked Medially Linked Knee-Ankle-Foot Orthoses

The purpose of this study was to compare the effect of knee unlocked medially linked Knee-Ankle-Foot Orthoses (MLKAFO) to the conventional knee locked MLKAFO during walking by means of Functional Electrical Stimulation (FES). A 33-year-old male with complete T8 paraplegia participated in this study. The stimulator has two hand switches to change the stimulation pattern. When the switch was turned on, the femoral nerve and paravertebral muscles were stimulated. When the switch was turned off, the femoral nerve stimulation was stopped. Two different types of MLKAFO were prepared for that study namely the knee locked MLKAFO and the knee unlocked MLKAFO. The gaits were measured by three-dimensional analysis system. Trunk anterior tilt and swing leg time in initial swing phase and lateral aspect of gait were evaluated. The results revealed that trunk anterior tilt with knee unlocked MLKAFO was smaller than that of knee locked MLKAFO. Swing leg time in initial swing with knee unlocked MLKAFO was faster than that of knee locked MLKAFO. We concluded that the knee unlocked MLKAFO was provided better performances. The stance leg with knee flexed produced the weight bearing shift forward and the swing leg with knee flexed enabled to start swinging leg faster.