sábado, 22 de maio de 2010

Reciprocating Gait Orthosis- RGO

Reciprocating Gait Orthosis- RGO
Photos and artwork courtesy of Fillauer Inc.

A reciprocating gait orthosis (RGO) is also a HKAFO however it allows one leg to be placed ahead of another - more like normal walking. This is achieved by linking the two KAFOs together by a band, two cables or a push-pull rod which transfers movement energy from one leg to the other (see diagram). Therefore as one leg is flexed or brought forward, it causes a reciprocal extension of the other leg. This allows a much smoother gait and greatly reduces the amount of effort that is needed to walk. A walker can often be abandoned for forearm crutches.
RGOs tend to be most successfully used for children with spina bifida starting as young as 2.5 years old but have been used by children with other diagnoses. RGOs are sometimes used for adult paraplegics but often a wheelchair becomes the preferred mode of transportation for the adults.
The RGO is commonly used for individuals with a lesion level of T12 to L3 (although higher levels are possible) who lack adequate strength to maintain hip extension. Good upper extremity strength, high motivation levels, good family support and minimal contractures definately contribute to the successful use of the device.
A hip-knee-ankle-foot orthosis (HKAFO) consists of a trunk section connected to two KAFOs by two lateral hip joints. These joints usually have locks that can be disengaged for sitting. Movement with an HKAFO is achieved by a swing through or hopping type gait with the assistance of either a walker or forearm crutches with both legs are moved together as one unit.
RGO Introduction
The Reciprocating Gait Orthosis or RGO is the most frequently used brace for the ambulatory needs of a paralyzed child or adult. There are other types of RGO's presently in use, the dual-cable and horizontal cable. RGO braces provide excellent walking function as compared to other devices. Hands-free standing and the use of the orthosis counteracts the tendency for hip contractures. With every step, as one leg flexes, the other leg must extend and thereby stretch out the hip contracting structures. Agile patients can be fitted as early as 18 months of age, giving them a better chance for walking and standing and therefore enjoying earlier the physiological, skeletal and psychological benefits of being upright.
The RGO is a walking brace for people with little or no control of their lower extremities often due to neuromuscular disorders or injuries. The device is ideally suited for patients with spina bifida, traumatic paraplegia, muscular dystrophy, and osteogenisis imperfecta.

RGO offers the following advantages:

  • Efficient ambulation - compared to other forms of bracing, RGO is more energy efficient. This saves exertion for people with muscle weakness. Also for patients prone to weight gain the ease of walking encourages more physical activities. The hip muscles that are used for walking are exercised and conditioned as the person walks in the brace.
  • "Hands-free" standing, balance and support - Wearers can have their hands available for activities of function while standing. The brace not only stabilizes the hip, knee and ankle joints but it also balances (positions) the person so they can stand without the use of crutches or walkers.
  • Dynamic "hip stretching" - Many Spina Bifida and people with paraplegia are prone to hip flexion contractures. This tendency is counteracted by the fact that the brace connects the two legs in such a way that flexing of one leg causes extension of the opposite side.
  • It is like getting therapy or stretching with every step a person takes.

  • Steps are achieved by advancing the leg one of three ways.
    1.   Use of hip flexor muscles.
    2.   Use of lower abdominal muscles.
    3.   Use of trunk extension
RGO torso sections combine durability and innovation. The pelvic band is made of high strength aluminum. It is designed to be very strong and rigid. This unique pelvic band design, keeps the legs tracking so one does not interfere with the other. This permits easier walking, less gait training time and less energy consumption. The reciprocal mechanism is the simplest, most durable and of least friction available. The "single lateral side bar" design makes the donning and doffing of the brace a simple, easy and quick operation.

  • Order separately or as complete
  • RGO (Torso section does not include leg section.)
  • Very durable and friction-free reciprocator.
  • Custom made to cast or measurements.
  • Pelvic band available in light or regular duty.
  • Can be made with a detachable body jacket.
  • Unique hip joints – pre-selected, abduction-hinge and quick disconnect.
 Child RGO
  • Includes torso and leg section.
  • Custom made to cast and measurements.
  • Comes with single lateral side bars.
  • Can be ordered with regular or external AFO's.
  • Very user friendly.
  • Delivered ready for fitting.
  • Provide casts of torso if spinal deformity is present.
  • Provide cast of legs for fabrication of leg braces.

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