A comparison of hip guidance with reciprocating gait orthoses in children with spinal paraplegia: Results of a ten-year prospective study

Twenty-two children with spinal paraplegia were entered into a prospective randomised study to assess the efficacy of two reciprocating orthoses and t o identify any prognostic factors that might affect continuing use of the d evices. Thirteen received a hip guidance orthosis (HCO) and nine a reciproc ating gait orthosis (RGO). They were followed for a mean of ten years. At o ne year follow-up there were three statistically significant differences be tween the two groups at the 5% level: repairs were commoner in the RGO grou p, the RGO group improved in their ability to walk over difficult outdoor s urfaces and the HGO group improved more in their ability to rise from a sit ting to standing position. At one year follow-up there was a positive paren tal and child's view of the benefits of the orthoses, but by ten years only 24% of the patients were still using the orthoses. We were not able to sho w any definite advantage of one device over the other or any statistically significant prognostic factors far walking in the longer term with a recipr ocating orthosis. We question whether or not the routine provision of these types of orthosis is justifiable when it appears that, in the longer term, the patients we studied preferred wheelchair mobility.