F-4-04-01
A NEW MEDIAL SINGLE HIP JOINT FOR PARAPLEGIC WALKERS
E. Saitoh, M. Baba, S. Sonoda*, Y. Tomita*, M. Suzuki, & M. Hayashi**
(Fujita Health University, Aichi; *Keio University, Tokyo; **Tatematsu Industries Co., Aichi, Japan)
The RGO system is the most popular way among orthotic solutions for walking of paraplegics, however, existence of en bloc portion of hard trunk portion and bilateral hip joints in the system makes both sitting and the usage of a wheel chair difficult. This problem seems to inhibit the usage of this system in the ADL.
In 1992, a system using detachable medial single hip joint (MSH) was invented in Australia (Polymedic Co). We tested this system clinically and confirmed its benefit in solving the above-mentioned problem. Simultaneously, however, we found a new problem due to spatial discrepancy between the axes of MSH and that of patient's hip joints. When a patient swings his leg more widely, this discrepancy causes his pelvic to rotate, which leads to his losing balance during walking.
We solved this discrepancy problem by developing a new MSH which has a virtual axis based upon gear mechanism. In our presentation we will show our new MSH and report the data on walking comparing with the conventional MSH.
F-4-04-02
RESTORATION OF STANDING IN PARAPLEGIA BY MEANS OF FUNCTIONAL ELECTRICAL STIMULATION
K. Ihashi, Y. Matsumura, R. Yagi, Y. Handa (Tohoku University, Sendai, Japan)
Purpose: We developed a FES system using percutaneous intramuscular wire electrodes and a portable multi-channel stimulator to restore motor function. The purpose of this study was to clarify the effect of our FES system for restoration of standing function in paraplegic patients.
Method: The patients were 4 paraplegics at T4 to T12 lesion levels due to spinal cord injury or spinal vascular accident. The patients underwent electrodes implantation at 15 to 120 months after the on set. Training stimulation for muscle strengthening was performed for 5 to 12 months. The quadriceps femoris, gluteus maximus, gluteus medius, adductor magnus, tibialis anterior and tbial nerve were stimulated to restore standing. A hand switch was used to control stimulation.
Result: All patients succeeded in FES standing in a parallel bar. The support of upper extremity was required to maintain balance, but any orthotics were not needed. All patients could maintain standing for 30 to 70 minutes. They got standing ability at 1 or 2 weeks after the beginning of FES standing trial except for one patient who had severe orthostatic hypotension.
Conclusion: Standing function in the paraplegics was restored by FES without the aid of orthotics. It is considered that our FES system is useful way to restore standing function in paraplegics.
