Evidence-Based Evaluation of Physiological Effects of Standing and Walking in Individuals with Spinal Cord Injury

Iran J Med Sci, 2011 · DOI: · Published: December 1, 2011

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

Spinal Cord Injury (SCI) results in loss of mobility and sensation. While wheelchairs provide mobility, they can lead to health issues like pressure sores and osteoporosis. This review examines the evidence supporting the benefits of standing and walking with orthoses for SCI patients. The review found conflicting evidence regarding the effectiveness of orthoses in improving the health of SCI patients. Many studies relied on user comments rather than strong clinical evidence. The review aimed to find solid evidence on the physiological effects of orthoses on individuals with SCI. Despite claims of benefits like improved bone density and digestive function, strong evidence only supported improvements in independent living and physiological health. Most published studies were surveys collecting questionnaire-based information from orthosis users.

Study Duration

Not specified

Participants

SCI patients

Evidence Level

Review Article

Key Findings

1
Evidence supporting the effectiveness of orthoses for improving the health condition of SCI patients is controversial.
2
Improving independent living and physiological health were the only two benefits supported by strong evidence.
3
Most published studies are surveys collecting questionnaire-based information from the users of orthosis.

Research Summary

This review assesses the physiological effects of standing and walking with orthoses for individuals with Spinal Cord Injury (SCI). It addresses the question of whether sufficient evidence supports the claimed benefits of these activities, such as decreasing bone osteoporosis and improving digestive system function. The review of literature indicates that the evidence is controversial. While benefits such as decreasing bone osteoporosis, preventing joint deformity, and improving bowel and bladder function are mentioned, many studies rely on user comments. The review concludes that there is no strong evidence that the use of orthosis can decrease bone osteoporosis, muscle spasm, and improve general health. It recommends that the use of orthosis for standing and walking must be long-life to have any influences on the health status of SCI patients.

Practical Implications

Clinical Practice

Clinicians should carefully evaluate the evidence when recommending orthoses for SCI patients, considering the limited support for many claimed physiological benefits.

Research

Future research should focus on conducting rigorous clinical trials with larger sample sizes and standardized outcome measures to assess the true impact of orthoses on the health of SCI patients.

Orthotic Design

The design of orthoses should prioritize ease of use and comfort to improve patient adherence, addressing issues such as donning and doffing challenges and high energy expenditure.

Study Limitations

1
Many studies are survey-based and rely on user comments rather than objective measurements.
2
The evidence regarding the effectiveness of orthoses for improving the health condition of SCI patients is controversial.
3
The review highlights a lack of strong evidence supporting many of the claimed physiological benefits of standing and walking with orthoses.

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