Long-Term Clinical Experience with the Reciprocating Gait Orthotic System
EDWARD M. ROGOWSKI, JAMES M. FEZIO, C.O., AND JOHN V. BANTA, M.D.
Since the preliminary reports on the design and fabrication of the Reciprocal Gait Orthosis there have been no longterm analyses of the effectiveness of the orthosis to provide reciprocal gait for patients with thoracic and high lumbar levels of paralysis.
The purpose of this study was to analyze the indications, use, and acceptance of the RGO's delivered between 19821991 at Newington Children's Hospital to 48 consecutive patients. There were 37 males and 11 females, ranging in age between 1 + 4 years and 43 + 7 years with a mean age of 12.9 years at time of brace delivery. The major diagnoses were myelomeningocele in 31 patients (65%), spinal cord injury in 13 patients (27%), and 4 patients with other associated neuromuscular diseases (8%). The lesion level of paralysis as determined by the lowest antigravity neurosegmental level for children ranged from T4-L3 with a median of T12. The functional lesion level for the adult patients ranged from C6-L2 with a median level of T6.
Of 32 children, only 16 continued to ambulate, and 11 used the RGO. Of 16 adults, 5 were lost to followup, 2 walked with the RGO, and 1 uses the ParaWalker system. Average brace wear time was 6.3 hr/day for children and 1.2 hr/day for adults.
These results indicate that for the child with paraplegia, age, and level of paralysis, are the most important determinants of successful use of the RGO, and most children discontinue brace use between 7V2 and I I V2 years of age. 14 of the 16 adults discontinued the RGO primarily due to difficulty in donning and doffing the brace and the inability to walk independently.
Newington Children's Hospital, 181 E. Cedar St., Newington, CT 06111