Orthotic options for standing and walking

Abstract

Standing and walking are key goals of rehabilitation. Standing requires an anteriorly directed force at the mid back, complemented by posteriorly directed forces from the chest and legs. Standing benefits the patient physiologically and psychologically. Orthoses, including frames, swivel walkers, and the parapodium, foster crutchless standing. Walking requires stability plus some means of shifting weight and advancing the legs individually or together. Limited ambulation may be achieved with ankle-foot orthoses, knee-ankle-foot orthoses, and trunk-hip-knee-ankle-foot orthoses, including various versions of reciprocating gait orthosis. Each type of orthosis is described, including its availability for children and adults and its advantages and disadvantages.