ORIGINAL RESEARCH ARTICLE Effect of Orthotic Rehabilitation with Isocentric Reciprocating Gait Orthosis on Functional Ambulation in Patients with Spinal Cord Injury Mokhtar Arazpour, PhD, Mohammad Samadian, MD, Mohammad Ali Mardani, PhD, Mahmood Bahramizadeh, PhD, Kaveh Ebrahimzadeh, MD, Reza Vahab Kashani, MSc, Mohammad Ebrahim Mousavi, MD ABSTRACT Objectives: Functional ability defines a person's ability to walk, with or without the aid of appropriate assistive devices, safely and sufficiently to carry out mobility-related activities of daily living. Longitudinal evaluation of the efficiency of gait training posi- tively affecting these parameters has not been reported. Therefore, the aim of this study is to provide evidence supporting the progression of walking speed and functional ambulation over 12 weeks of orthotic gait rehabilitation using an isocentric recip- rocating gait orthosis (IRGO) in patients with spinal cord injury (SCI). Materials and Methods: Twelve patients with SCI participated in this study. Gait evaluation was performed at baseline and at 4, 8, and 12 weeks following intervention with an IRGO and specific gait training. Gait speed and endurance were measured by the 10-m walk test and the 6-minute walk test, respectively. The Functional Independence Measure (FIM) locomotor subscale and the Walking Index for Spinal Cord Injury II (WISCI II) were used to measure the locomotor ability. Results: Improvement in speed of walking was observed after 4 weeks and continued to improve with time. The distance of walk- ing, FIM, and WISCI also increased significantly during the study period when compared with the baseline. Conclusion: Patients with SCI showed an increase in walking functional ambulation ability during a longitudinal period of or- thotic gait training with an IRGO. In conclusion, wearing IRGO associated with gait training can provide individuals with thoracic-level SCI the ability to walk faster. (J Prosthet Orthot. 2017;29:80–87) KEY INDEXING TERMS: isocentric reciprocating gait orthosis, walking, orthotic gait training, spinal cord injury, paraplegia, 10-m walk test, 6-minute walk test, functional ambulation O rthotic gait rehabilitation in patients with spinal cord injury (SCI) has several advantages from the physiolog- ical and psychological point of view. 1–3 Body-weight- supported treadmill training strategies have been introduced as a promising approach to improve gait in SCI patients. 4 This system is basically used in a clinical environment as it is difficult to use this system in homes. An orthotic system (e.g., powered gait orthoses, hybrid orthoses, and mechanical orthoses) is another system that is used in the orthotic gait rehabilitation in SCI patients. 5 The most simple and traditional approach to enable standing and walking in patients with SCI is the use of purely mechanical orthoses. 1 Among the mechanical orthoses, the isocentric recip- rocating gait orthosis (IRGO) has been reported to be the most effective orthosis in improving walking parameter and energy consumption. 1–3 The design of the IRGO was originally based on the concept of facilitating a reciprocal gait pattern for para- plegic patients and is therefore commonly prescribed for SCI patients for walking and standing. It consists of two knee-ankle- foot orthoses (KAFOs) connected laterally to a superstructure MOKHTAR ARAZPOUR is affiliated with the Pediatric Neuro- rehabilitation Research Center, Iranian Research Center on Aging, and Orthotics and Prosthetics Department, University of Social Wel- fare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran. MOHAMMAD SAMADIAN is affiliated with the Loghman Hakim Hospi- tal, Shahid Beheshti University of Medical Sciences, Department of Neu- rosurgery, Tehran, Iran. MOHAMMAD ALI MARDANI is affiliated with the Orthotics and Pros- thetics Department, University of Social Welfare and Rehabilitation Sci- ences, Tehran, Islamic Republic of Iran. MAHMOOD BAHRAMIZADEH is affiliated with the Orthotics and Pros- thetics Department, University of Social Welfare and Rehabilitation Sci- ences, Tehran, Islamic Republic of Iran. KAVEH EBRAHIMZADEH is affiliated with the Loghman Hakim Hospi- tal, Shahid Beheshti University of Medical Sciences, Department of Neu- rosurgery, Tehran, Iran. REZA VAHAB KASHANI is affiliated with the Orthotics and Prosthetics Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran. MOHAMMAD EBRAHIM MOUSAVI is affiliated with the Orthotics and Prosthetics Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Islamic Republic of Iran. Disclosure: The authors declare no conflict of interest. Copyright © 2017 American Academy of Orthotists and Prosthetists. Correspondence to: Kaveh Ebrahimzadeh, MD, Loghman Hakim Hos- pital, Shahid Beheshti University of Medical Sciences, Department of Neurosurgery, Kamali St, Lashgar Cross Rd, Kargar Ave 1333635445 Tehran, Iran; email: Dr.kavehebrahimzadeh@gmail.com 80 Volume 29 • Number 2 • 2017 Copyright © 2017 by the American Academy of Orthotists and Prosthetists. 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