Rehabilitation program using a computer-controlled knee-ankle-foot orthosis for a patient with incomplete spinal cord injury: A case report

The computer-controlled knee-ankle-foot orthosis C-brace (OttoBock, Duderstadt, Germany) reportedly improves walking ability and balance. However, the physical therapy contents and duration needed to obtain these benefits have not been described. Therefore, we present a rehabilitation program designed to achieve walking ability using the C-brace in a patient with chronic traumatic incomplete spinal cord injury (iSCI). A 53-year-old man with chronic traumatic iSCI was able to walk with braces and aids after undergoing outpatient physical therapy using a C-brace at a university hospital. The patient underwent 11 sessions of physical therapy for a total of 545 min to achieve independent walking using the C-brace. Most of that time was spent on independent gait training with the C-brace: 150 min of swing phase training, 125 min of outdoor gait training, and 60 min of training on the stepper and ramp. His walking ability, balance, and ability to ascend and descend stairs improved, whereas fear of falling decreased. The C-brace may aid in these improvements; however, the benefits may not be immediate and require a certain amount of training. Clinicians need to set up the orthosis and provide a thorough explanation of its functional properties to patients to maximize its benefits.