OBJECTIVE MEASUREMENT OF USE OF THE RECIPROCATING GAIT ORTHOSIS (RGO)AND THE ELECTRICALLY AUGMENTED RGO IN ADULT PATIENTS WITH SPINAL-CORDLESIONS

The purpose of the study was to measure objectively the home use of th e reciprocating gait orthosis (RGO) and the electrically augmented (hy brid) RGO. It was hypothesised that RGO use would increase following p rovision of functional electrical stimulation (FES). Five adult subjec ts participated in the study with spinal cord lesions ranging from C2 (incomplete) to T6. Selection criteria included active RGO use and sui tability for electrical stimulation. Home RGO use was measured for up to 18 months by determining the mean number of steps taken per week. D uring this time patients were supplied with the hybrid system. Three a lternatives for the measurement of steps taken were investigated: a co mmercial digital pedometer, a magnetically actuated counter and a heel contact switch linked to an electronic counter. The latter was found to be the most reliable system and was used for all measurements. Addi tional information on RGO use was acquired using three patient diaries administered throughout the study and before and after the provision of the hybrid system. Testing of the original hypothesis was complicat ed by problems in finding a reliable measurement tool and difficulties with data collection. However, the results showed that overall use of the RGO, whether with or without stimulation, is low. Statistical ana lysis of the step counter results was not realistic. No statistically significant change in RGO use was found between the patient diaries. T he study suggests that the addition of electrical stimulation does not increase RGO use. The study highlights the problem of objectively mea suring orthotic use in the home.