Notes on Reciprocating Gait Orthosis and Related Orthopedic Devices

Overview

• Reciprocating Gait Orthosis (RGO): Designed to aid individuals with neuromuscular or neurological issues in walking, particularly those with paraplegia due to spinal cord injuries or conditions like spina bifida.
• Development: Evolved through collaboration at LSU Medical Center and Fillauer, Inc.
• Purpose: Aims to offer a more natural and efficient method of ambulation by coordinating hip joint motions.

Key Orthotic Devices

1. Parapodium

• Purpose: Allows standing without crutches and encourages development of upper body strength.
• Construction: Aluminum, modular design for growth adjustments.
• Advantages: Hands-free while standing, practical mobility, easy donning/doffing.

2. Fillauer Standing Frame

• Design: Offers stability for children, available in different sizes and models for hip abduction.

3. Reciprocating Gait Orthosis

• Construction: Lightweight plastic, carbon fiber reinforcement at ankles.
• Functionality: Coupled hip joints provide a reciprocating gait by coordinating leg movements.
• Components: Available in various styles (hooped, horizontal, rocker bar).

Indications for RGO Use

• Physical Criteria: Plantigrade feet, flexible hips, good upper body strength, supportive family environment.
• Goals: Improve standing posture, prevent contractures, facilitate walking with low energy expenditure.

Contraindications for RGO Use

• Severe contractures, obesity, poor upper body strength, or spasticity that limits mobility.

Surgical Interventions

• Goal: Correct deformities early to allow effective orthotic fitting. Focus on foot, hip, knee, and spinal deformities.
• Procedures: Tendon transfers, soft tissue corrections, orthopedic surgeries for alignment and correction.

Physical Therapy and Training

• Preparation: Begins with Parapodium training, then moves to RGO.
• Exercises: Include weight bearing, postural alignment, and strength training.
• Functional Training: Gait training, sitting balance, and ADL skills.

Fabrication and Fitting

• Casting and Measurement: Detailed process for accurate fitting.
• Pelvic Girdle: Custom molded for each patient, crucial for proper alignment.
• RGO Assembly: Includes various cable systems (hooped, horizontal) and components for specific patient needs.

Types of RGOs

• Hooped Cable RGO: Known for simplicity and adjustability.
• Horizontal Cable RGO: Popular for cosmetic and functional reasons.
• Rocker Bar RGO: Features low maintenance and efficient design.

Summary

• Contact Information: Fillauer, Inc., Chattanooga, TN for orders and support.
• Instructional Materials: Available for practitioners to assist in fitting and training.

In conclusion, the Reciprocating Gait Orthosis and related devices are instrumental in improving mobility and quality of life for patients with lower limb disabilities. The integration of advanced orthotic technology and physical therapy offers significant benefits in terms of ambulation and overall functionality.