Paraplegia is a severe disability of lower limbs resulting from spinal cord injury. Moreover, its incidence has been climbing over the recent years. The most important symptom of paraplegia is the loss of walking ability. Involved researches during recent 40 years have shown that functional electrical stimulation, which could successfully regain some movement function for paraplegic patients, is a new and promising technique in modern rehabilitation engineering. It has been drawing more attention. Here, aiming at this functional electrical stimulation technique for paraplegic walking, we introduce its relevant background knowledge and research progress.
Electric Stimulation Therapy ; instrumentation ; trends ; Humans ; Paraplegia ; rehabilitation ; Walking

The purpose of this study was to investigate the effect of wheelchair ergometer training on spinal cord-injured paraplegics. Eleven male paraplegics with a mean age of 30.9 years (range, 20 to 49 years) participated in the wheelchair ergometer training for the period of 5 weeks. The mean peak heart rate, the mean peak systolic blood pressure and the mean time required for 100m wheelchair propelling at resistance level 1 were significantly decreased at the end of 5 weeks of training as compared with those at pre-training. There was no statistically significant difference in pulmonary function test at pre- and post-training. The peak torque of shoulder flexor and the total work of shoulder flexor and extensor at 180 degrees/sec after training were increased more significantly than those prior to the training. In accordance with the findings as revealed above, it is deemed that the endurance and strength of the upper body and the cardiac fitness for spinal cord-injured paraplegics may be improved by the wheelchair ergometer exercise
Adult ; *Exercise Therapy ; Human ; Male ; Middle Age ; Paraplegia/etiology/*rehabilitation ; Spinal Cord Injuries/complications/*rehabilitation ; *Wheelchairs

This report describes a case of acute flaccid paralysis after administration of oral polio vaccine (OPV). A 4 month-old male patient with the decreased movement of left lower extremity for 1 month was transferred to the Department of Pediatrics. He received OPV with DTaP at 2 months of age. Flaccid paralysis was detected 4 weeks after OPV immunization. Attempts to isolate Sabin-like viruses in the two stool and CSF samples failed because those specimens were collected more than 2 month after the onset of paralysis. Hypotonic monoparesis (GIV/V), hypotonia and atrophy on the left lower extremity, and ipsilateral claw foot persisted for more than 18 months, while we followed him with rehabilitation therapy. This is the first case of officially approved, recipient vaccine-associated paralytic poliomyelitis in Korea.
Poliovirus Vaccine, Oral/*adverse effects ; Poliomyelitis/*chemically induced/diagnosis/rehabilitation ; Paraplegia/*chemically induced/diagnosis/rehabilitation ; Male ; Infant ; Humans

The purpose of this study was to compare gait pattern and energy consumption in children with spastic diplegic cerebral palsy, when using anterior and posterior walkers, and to determine which walker should be recommended as a walking aid for these children. Ten spastic diplegic cerebral palsied children, of average age 9 years, were enrolled in this study. Before assessment, they had all received a practice period of 1-month to familiarize themselves with both types of walker. Gait characteristics were evaluated by computer-based kinematic gait analysis using Vicon 370 Motion Analysis, and energy expenditure was determined by KBI-C while they were using the walkers. The oxygen consumption rate was significantly lower whilst using the posterior walker, as was the oxygen cost. Walking velocity and cadence on gait analysis showed no significant difference between the walker types. However, step length, single support time and double support time were significantly different for the two walkers. Flexion angles of the trunk, hip and knee were lower using a posterior walker. Gait analysis data and oxygen consumption measurements indicated that the posterior walker has more advantages in terms of upright positioning and energy conservation than the anterior walker.
Biomechanics ; Cerebral Palsy/rehabilitation* ; Cerebral Palsy/physiopathology* ; Cerebral Palsy/complications ; Child ; Comparative Study ; Energy Metabolism* ; Equipment Design ; Female ; Gait* ; Human ; Male ; Paraplegia/rehabilitation* ; Paraplegia/physiopathology* ; Paraplegia/complications ; Walkers/standards*

Great importance and caution should be placed on prosthetic fitting for a paraplegic patient with an anesthetic residual limb if functional ambulation is to be achieved. The combination of paraplegia with a transfemoral amputation and radial nerve palsy is a complex injury that makes the rehabilitation process difficult. This article describes a case of L2 paraplegia with a transfemoral amputation and radial nerve palsy on the right side. Following the rehabilitation course, the patient independently walked using a walker at indoor level with a transfemoral prosthesis with ischial containment socket, polycentric knee assembly, endoskeletal shank and multiaxis foot assembly and a knee ankle foot orthosis on the sound side. The difficulties of fitting a functional prosthesis to an insensate limb and the rehabilitation stages leading to functional ambulation are reviewed.
Adult ; Amputation* ; Artificial Limbs* ; Case Report ; Femur/surgery* ; Human ; Male ; Paraplegia/rehabilitation* ; Radial Nerve*

STUDY DESIGN: Retrospective study. PURPOSE: The goal of care for paraplegic people is the enhancement of their "well-being". However, despite the frequent use of the term "well-being", its definition remains unclear and there is little information in the literature concerning the paraplegic's own perspective. The study was conducted to explore the Pakistani paraplegia's perspective of well-being. OVERVIEW OF LITERATURE: Studies have shown that paraplegia changes not only physical and psychological, but also socioeconomic, states, which have significant impact on an individual's "subjective well-being", however there is no clear definition of well-being and the methods of measuring the phenomena. METHODS: Fifty paraplegic adults from different rehabilitation centers of Pakistan participated in an in-depth interview using natural inquiry method. The interviews were audio-taped, transcribed, and analyzed. RESULTS: Three commonly used meanings of well-being and eight components were identified and included in the definition. The results indicated that the meaning of well-being is an individual's perception, which includes both objective and subjective values and experiences. CONCLUSIONS: The study provides information that was used to develop specific rehabilitation program for the paraplegic Pakistani adults to enhance their well-being.
Activities of Daily Living ; Adult ; Humans ; Pakistan ; Paraplegia ; Rehabilitation Centers ; Retrospective Studies ; Spinal Cord Injuries

OBJECTIVE: To investigate the characteristics, predictors, and consequences of pressure ulcers and to provide prospective epidemiologic data. METHOD: The prospective data of 100 patients with pressure ulcers were collected who were admitted to the department of rehabilitation medicine of 4 hospitals from 2002 June to 2003 September. We have collected the informations on clinical features of pressure ulcer prospectively. RESULTS: Quadriplegia/Tetraplegia was the most commonly involved type of injury, followed by hemiplegia, paraplegia. Most patients developed pressure ulcer before they were transferred to the rehabilitation unit. The average Braden scale scores was 13.06+/-3.46 and were 16 point or below in 80% of patients, and this point was considered as the cut-off score of the patients with high risk. Sacrum was the most common site of the ulcers and most ulcers were 2nd and 3rd stage. The ulcers were treated with conservative (82%) or surgical management (18%). The more severe and larger ulcers required the surgical management. CONCLUSION: The results of this prospective study on clinical features would be helpful for the understandings, prevention and management of pressure ulcers.
Epidemiologic Studies* ; Epidemiology ; Hemiplegia ; Humans ; Paraplegia ; Pressure Ulcer* ; Prospective Studies* ; Rehabilitation ; Sacrum ; Ulcer

Vascular disease of the spinal cord occurs less frequently than of the brain, and its incidence is not known. Case reports of spinal cord infarction are uncommon, especially ones with spontaneous causes. We experienced one case with a spontaneous spinal cord infarction in the territory of the Adamkiewicz artery. In this case, the clinical pictures were characterized by sudden onset of paraplegia, bilateral radicular pain, dissociated sensory loss below the level of infarction and sphincter dysfunction. Neuroradiological investigation and CSF analysis ruled out compressive or infectious lesions. Selective spinal angiography revealed an occlusion of the Adamkiewicz artery. The patient had a substantial recovery over a period of weeks with intensive rehabilitation treatments.
Angiography ; Arteries ; Brain ; Humans ; Incidence ; Infarction* ; Paraplegia ; Rehabilitation ; Spinal Cord* ; Vascular Diseases

In neurogenic equinovarus deformity, surgical intervention such as tendon transfer or osteotomy can be expected to improve symptoms. However, in rare cases of hereditary spastic paraplegia, the deformity and paralysis gradually progress. So limited operation and early post-operative rehabilitation are preferred to aggressive operation. We would like to report our clinical experience with one case of hereditary spastic paraplegia patient with reference review. A 40 year-old male, given tendon transfer of ankle and foot and tendo achilles lengthening 10 years ago, complained about aggravated spastic paraplegia which resulted in dynamic equinovarus and limited walking ability since his operation. Family history showed limited walking ability of his father with gradually progressing spastic paralysis and he was diagnosed as hereditary spastic paraplegia type I. We had performed a limited operation such as tendo achilles and tibialis posterior lengthening to induce plantigrade standing and walking with crutch. As a result, the patient was able to maintain a stabilized standing posture and walk after the operation. Hereditary spastic paraplegia presents with a progressive paralysis which limits rehabilitation after tendon transfer, and the symptoms can be aggravated. Therefore, considering potential hereditary neurogenic disorders in paients with equinovarus deformity and performing limited operative procedures seem to be important.
Adult ; Ankle ; Clubfoot* ; Congenital Abnormalities* ; Fathers ; Foot ; Humans ; Male ; Muscle Spasticity ; Osteotomy ; Paralysis ; Paraplegia ; Posture ; Rehabilitation ; Spastic Paraplegia, Hereditary* ; Surgical Procedures, Operative ; Tendon Transfer ; Walking

OBJECTIVE: To evaluate the clinical features that could serve as predictive factors for improvement in gait speed after robotic treatment. METHODS: A total of 29 patients with motor incomplete spinal cord injury received 4-week robot-assisted gait training (RAGT) on the Lokomat (Hocoma AG, Volketswil, Switzerland) for 30 minutes, once a day, 5 times a week, for a total of 20 sessions. All subjects were evaluated for general characteristics, the 10-Meter Walk Test (10MWT), the Lower Extremity Motor Score (LEMS), the Functional Ambulatory Category (FAC), the Walking Index for Spinal Cord Injury version II (WISCI-II), the Berg Balance Scale (BBS), and the Spinal Cord Independence Measure version III (SCIM-III) every 0, and 4 weeks. After all the interventions, subjects were stratified using the 10MWT score at 4 weeks into improved group and non-improved group for statistical analysis. RESULTS: The improved group had younger age and shorter disease duration than the non-improved group. All subjects with the American Spinal Injury Association Impairment Scale level C (AIS-C) tetraplegia belonged to the non-improved group, while most subjects with AIS-C paraplegia, AIS-D tetraplegia, and AIS-D paraplegia belonged to the improved group. The improved group showed greater baseline lower extremity strength, balance, and daily living function than the non-improved group. CONCLUSION: Assessment of SCIM-III, BBS, and trunk control, in addition to LEMS, have potential for predicting the effects of robotic treatment in patients with motor incomplete spinal cord injury.
Gait* ; Humans ; Locomotion ; Lower Extremity ; Paraplegia ; Quadriplegia ; Rehabilitation ; Robotics ; Spinal Cord Injuries* ; Spinal Cord* ; Spinal Injuries ; Walking