i. yrs age with spina bifida the
i. HIP GUIDENCE ORTHOSIS (HGO)
A hip guidance orthosis (HGO), also known as the Orthotic Research and Locomotor Assessment Unit (ORLAU) Parawalker, developed to overcome the disadvantages of swivel walker
· HKAFO with free-moving hip joints that allow a reciprocal gait pattern
· To offer patients to walk reciprocally with crutches
· It consists of bilateral KAFOs with all bearing hip joint along with body brace
· Movement is preferred via trunck motion transmitted to the lower legs with help of hip flexion and extension.
· Hip Flexion – restriced by stop
· HIP Extension – limited or free
Reciprocation Gait Orthosis
These are often presecribed for the patients with post Spinal Cord Injury paralysis or coordinates similer to the post polio paralysis. In children from 2.5 yrs age with spina bifida the RGOs are successfully being used. A majority of the adult patients with paraplegics preferred to use wheel chair for transportation but RGOs offer a better and attractive kind of freedom.
RGO is a highly specialized orthotic device which works on the reciprocating gait principle. It means that when patient flexes his right hip, the device provide the stability to the patient by providing the extension of the left hip. This allows the patient to stand without support and walk . With the time passing the technology has made it more comfortable for patients to walk with RGOs.
This is the only device that permits the hands free standing without immobilizing the hips.
The legs are linked with the torso section.so the hip flexion and extension movements can freely occur while standing to take steps. But the torso is restricted from forward flexion.
· Provides maximum stability at hip, knee, foot and ankle joints
· It can be manufactured from plastic , carbon somposites and hybrid variations
TYPES OF RGO
HIP JOINT OPTIONS : Free, Variable Range of motion, Flexion , Extension , Abduction, Fixed, Locked, off –set
KNEE JOINT OPTIONS: Free, Drop Locak, Stance Control , Off-set Knee, Extension assist, Electronic control , Variable range of motion , Fixed range of motion
ANKLE JOINT OPTIONS: Solid, Semi Rigid , Articulated, Double Action, Variable range of motion, planter and dorsiflexion, assists and stop.
ii. COMMON DESIGNS OF RECIPROCATING ORTHOSES (RGO)
A reciprocating gait orthosis (RGO) is an HKAFO that uses?a mechanical system that connects the two sides of the brace ?by an
· isocentric bar (IRGO),
· double cable (LSU RGO from Louisiana State University), or
· single push/pull cable?system (advanced RGO ARGO developed by Hugh
ISOCENTRIC RGOs The couple cables are replaced by the centrally pivoted bar and tie rod arrangement. A study shows that the Physiologic cost index is decreased in SCI patients while using the ISO Centric RGOs.
MECHANICAL RGOs concists of bilateral KAFOs , consists of licking knee joints, hip jointys, cutom molded pelvic girdle and thoracic aextension. TO prevent the simultaneous hip flexion the hip joints are coupled with cables. Through the cable the hip extension on one side coupled with hip flexion on the other side.
MODERN RGOs are supported with software and stepper motors.