Rehabilitation for the Reciprocating-Gait-Orthosis Candidate
CHERYL KING BURLEY, RPT*Miami, Florida
The reciprocating-gait orthosis has become prominent in the treatment and rehabilitation of the paralytic child. The orthosis is composed of a plastic pelvic girdle, a dual-cable coupling system and bilateral polypropylene knee-ankle-foot orthoses with hip and knee locks and reinforced ankles.
The pediatric clients we have seen, ages 3 to 19 years, are those with myelodysplasia, spinal cord injuries and cerebral palsy. With a team approach functional level, developmental skills, righting responses as well as musculoskeletal problems are considered. Contraindications noted are excessive hip- and knee flexion contractures.
Preparation begins with a parapodium or standing brace to establish an upright posture in the daily activities of the child. Upper-limb and trunk-strengthening exercises are necessary. Range of motion of lower limbs must be maintained via exercise or surgical procedures. Training progresses to the parallel bars where concepts of diagonal weight shift, hip and trunk extension, upper-limb use and swing-through of the lower limb are reinforced.
The advantages of the reciprocating-gait orthosis are that it is lightweight and allows free-standing balance, a dynamic hip-reciprocating, energy-efficient gait.
*Pediatric Physical Therapy, University of Miami/Jackson Medical Center, P.O. Box 106960, Miami, FI 33101