Reciprocating gait orthosis

Reciprocating Gait Orthosis (RGO) is a type of orthosis specifically designed to aid individuals with lower limb disabilities in walking. The RGO is a sophisticated device that encompasses the lower body, typically extending from the waist to the feet. It functions by linking the movement of one leg to the opposite, thereby enabling a reciprocal gait pattern. This article delves into the design, functionality, and clinical implications of the Reciprocating Gait Orthosis.

Design and Functionality

The Reciprocating Gait Orthosis consists of a rigid external frame, usually made from lightweight materials such as aluminum or carbon fiber, to minimize the energy required for movement. The key components include hip and knee joints that are mechanically linked in such a way that when one leg is advanced, the opposite leg moves backward. This linkage is often achieved through a cable system or mechanical gears.

The RGO is equipped with a pelvic band and thigh cuffs, which secure the orthosis to the user. Footplates or shoes are attached to the bottom of the orthosis to provide stability and support. The design also incorporates locking mechanisms at the knee joints to prevent buckling during the stance phase of the gait cycle.

Clinical Implications

Reciprocating Gait Orthoses are primarily used by individuals with lower limb paralysis or severe muscle weakness, such as those resulting from spinal cord injury, spina bifida, or muscular dystrophy. The RGO enables users to stand and walk with an assistive device, promoting independence and improving quality of life.

The benefits of using an RGO include improved cardiovascular health, enhanced bone density, and reduced risk of pressure sores due to prolonged sitting. Additionally, the upright posture facilitated by the RGO can improve respiratory function and digestion.

Fitting and Training

Proper fitting and training are crucial for the effective use of a Reciprocating Gait Orthosis. The process involves a multidisciplinary team including orthotists, physiotherapists, and occupational therapists. Initial fitting ensures that the RGO is customized to the individual's body dimensions and specific needs. Subsequent training sessions focus on teaching the user how to don and doff the orthosis, as well as how to walk with the device. Mastery of the RGO requires practice and patience, as users adapt to the mechanics of the device and develop the strength and coordination needed for walking.

Limitations

While the RGO offers significant benefits, it also has limitations. The device is relatively bulky and can be cumbersome to use in confined spaces. Additionally, the energy expenditure required for walking with an RGO is higher than that of normal walking, which may limit the distance that users can comfortably travel. Furthermore, the success of the RGO depends on the user's upper body strength and balance, as these are needed to control the movement and stability of the orthosis.

Conclusion

The Reciprocating Gait Orthosis represents a significant advancement in assistive technology for individuals with lower limb disabilities. By enabling a more natural gait pattern, the RGO enhances mobility and improves the overall well-being of its users. Despite its limitations, the RGO remains a valuable tool in the rehabilitation of individuals with severe mobility impairments.