For gait training of a patient with complete L2 spinal cord injury, which orthosis is most likely required for household ambulation?

• A. AFOs
• B. KAFOs with walker or crutches
• C. Hinged knee brace
• D. No device

Answer: (B)

Stability of the knee and control of the ankle are essential for safe gait when the injury is complete at a lumbar level. With complete L2 involvement, knee control is not reliably available, so a device that stabilizes both the knee and the ankle is needed for indoor walking.

A knee-ankle-foot orthosis with a walker or crutches provides that stability: the knee is held in extension, the ankle is aligned for proper foot placement, and the assistive device helps with balance and weight shifting during standing and stepping. This combination makes household ambulation feasible despite the loss of knee extension control.

An ankle-foot orthosis alone would leave the knee unstable, making a knee collapse or compensatory patterns likely. A hinged knee brace without proper ankle support still doesn’t provide the necessary control for safe ambulation after a complete L2 injury. No device would not be adequate for safe walking indoors in this scenario.

Therefore, the orthosis most suited for household ambulation after a complete L2 spinal cord injury is a knee-ankle-foot orthosis used with a walker or crutches.