USE OF THE RECIPROCATING GAIT ORTHOSIS IN MYELODYSPLASIA

There are advantages to an upright posture and ambulation in pediatric myelodysplasia patients. The reciprocating gait orthosis (RGO) is a u seful tool to enable this activity in selected individuals. We evaluat ed the long-term usage, pitfalls, and contraindications of this orthos is. Mean daily usage was 6.9 h/day, requiring an average of 10 min to don or doff; all patients required assistance. Obesity, advanced age, lack of patient or family motivation, scoliosis, and spasticity were s ignificant negative factors in long-term usage of the RGO. Good upper extremity strength, trunk balance, previous standing or walking, and a ctive hip flexion were important positive variables. Eleven of 21 pati ents did not persist with long-term usage of this orthosis, averaging 25.8 months of usage. An energy study was performed on three patients, comparing the efficiency of reciprocating gait and swing-through gait . All three were more energy efficient and two were faster with the sw ing-through gait but each preferred the reciprocating pattern. Care sh ould be taken when selecting patients for RGO usage because not all ch ildren with myelomeningocele are able to function effectively with thi s orthosis.