A clinical review of the adult hip guidance orthosis (ParaWalker) in traumatic paraplegics

Abstract

SummaryTwenty Adult traumatic paraplegics with neurologically complete lesions between C8 and T12 have ambulated using a ParaWalker (adult hip guidance orthosis), for a minimum of 6 months at home. At follow up, on average 20 months from the date of issue of the orthosis, 17 patients (85%) were still regularly using their Para Walker. Patients achieved independent use of the orthosis and low energy ambulation both indoors and outdoors on a variety of surfaces.A new classification of adult paraplegic ambulation using an orthosis is de scribed.

The use of an advanced reciprocating gait orthosis by paraplegic individuals: a follow-up study

“…This high score is comparable to the ®rst follow-up study on the HGO. 14 In that article, the remark was made that this number was probably so high because these users were highly motivated pioneers'. Indeed, in a second follow-up study at the same centre, 4 the number had dropped to 64%.…”

Clinical evaluation of a new orthosis, the `Walkabout', for restoration of functional standing and short distance mobility in spinal paralysed individuals

“…The demonstrated pattern of maintained usage by adult SCI individuals in the Walkabout orthosis, with a typical frequency of use between 1 ± 3 times per week and total duration of usage between 2 ± 3 hours per week, compares favourably with data previously published for the HGO. 9 Longer term follow-up will be required Figure 3 The Walkabout orthosis with corset attachment straps reversed and forearm crutches to monitor continued usage. Not surprisingly, orthotic ambulatory ability and con®dence were generally better in those where proprioception was preserved.…”

“…7,8 Although orthoses have enabled some individuals to overcome architectural barriers such as stairs or narrow doorways, 5 in practice most patients have found that the necessary accompanying walking aids interfere with task performance and that the wheelchair is more e cient for mobility. 9,10 Even so, a large proportion of paraplegic individuals still desire improved mobility to overcome the problems of inaccessibility. 11 In contrast to an earlier study reporting that braces prescribed during rehabilitation are frequently later abandoned, particularly in patients with a neurological lesion above T12, 12 several authors have now reported an encouraging trend towards continued long-term usage of orthoses for exercise with patients describing strong feelings of physical and psychological well-being associated with their use.…”

“…11 In contrast to an earlier study reporting that braces prescribed during rehabilitation are frequently later abandoned, particularly in patients with a neurological lesion above T12, 12 several authors have now reported an encouraging trend towards continued long-term usage of orthoses for exercise with patients describing strong feelings of physical and psychological well-being associated with their use. 9,13 Over the last 10 ± 15 years there has been renewed interest internationally in ambulation of paraplegic individuals with the attempted development of more mechanically e cient orthoses, experimentation with electrical stimulation 14 and recently several hybrid systems combining a mechanical orthosis with electrical stimulation. 15,16 Orthotic devices allowing paralysed individuals to stand and ambulate reciprocally include the Hip Guidance Orthosis (HGO), 17 the Louisiana State University-Reciprocating Gait Orthosis (LSU-RGO), 18 the modi®ed Douglas RGO, 16 the Advanced Reciprocating Gait Orthosis (ARGO), 19 the Isocentric RGO 20 and the Walkabout orthosis.…”

Energy cost of paraplegic locomotion with the ORLAU ParaWalker

“…Con trary to the previous experience of orthotic paraplegic walking, a recent survey (Summers et al, 1986) showed that 85() () of the patients were still regularly using their Para Walker at follow-up, on average 20 months from the date of supply of their orthosis. They all had a complete traumatic spinal cord injury between C8 and T12.…”