The development of Medial hip joint system for reconstruction of paraplegic locomotion

我们一直在开发的矫形系统称为内侧系统重建截瘫的站立和行走。该系统由内侧单髋关节（MSH）和双侧膝踝足矫形器（KAFO）组成，克服了日常使用中矫形器笨重和紧绷的缺点。1.为了进一步改进我们开发的改良MSH（Primewalk^R），我们在关节上添加了铰链机构，允许内外旋转10度。有了这个机制，病人似乎比没有它更容易转。在KAFO下站立，双侧膝盖必须锁定伸展位置。这对患者来说是一项非常艰巨的任务。因此，我们开发了MSH-KAFO与辅助装置，用于从屈曲位站立的膝关节伸展。该装置由螺旋弹簧制成，其强度为0.56kg/m。使用该系统，患者（Th 10，Frankel A）可以从双杠上的轮椅或步行者上站立起来。3.为了阐明MSH-KAFO根据损伤程度的效果，我们调查了24例使用MSH-KAFO进行站立和步行锻炼的患者。颈椎损伤患者可在康复室的一名物理治疗师的协助下站立和行走。胸椎损伤患者可自行或在一名理疗师的最低协助下使用步行者或Lofstrand拐杖行走。对于不同损伤程度的不完全性截瘫患者，从康复早期到实际行走，MSH-KAFO站立和行走训练都是有效的。

We have been developing the orthotic system called the medial system for reconstruction of paraplegic standing and walking. This system consists of a medial single hip joint (MSH) and bilateral knee-ankle-foot orthoses (KAFO) and overcomes the orthotic demerits of bulkiness and tightness in daily using. 1. For further refinement of our developing modified MSH (Primewalk^R), we added hinge mechanism to the joint permitting internal and external rotation ranging of 10 degrees. With this mechanism patients seemed to turn more easily than without it. 2. Standing up under KAFOs, bilateral knees must be locked with extension position. But it is very difficult task for patients. So we developed the MSH-KAFO with the assistive device for extension of knee standing up from the flexure position. The device is made with coiled spring which strength is 0.56kg m. The patient (Th10, Frankel A) could become to stand up from wheel chair in parallel bars or with walker using this system. 3. To clarify the effect of MSH-KAFO according to impairment level, we investigated 24 cases who have exercised standing and walking with MSH-KAFO. Patients with cervical spinal injury could stand and walk with assist of one physical therapist at rehabilitation room. Patients with thoracic spinal injury could walk with walker or Lofstrand crutches by themselves or minimum assist of one physical therapist. For incomplete paraplegics of various impairment levels, standing and walking exercise with MSH-KAFO was effective from early stage of rehabilitation and practical walking.