FUNCTIONAL OUTCOMES ATTAINED BY T9-12 PARAPLEGIC PATIENTS WITH THE WALKABOUT AND THE ISOCENTRIC RECIPROCAL GAIT ORTHOSES

Objective: To compare the functional outcomes attained by persons with paraplegia using the Walkabout Orthosis (WO) and the Isocentric Recip rocal Gait Orthosis (IRGO). Design: A randomized crossover design. Pat ients: Ten subjects with complete lesions between T9-T12. Intervention s: Over two 8-week periods, subjects were taught to use each orthosis in conjunction with elbow crutches. Main Outcome Measures: After each 8-week training period, subjects were assessed on their ability to per form five different sets of key skills associated with functional ambu lation. Results: There were no differences between orthoses in the abi lity of subjects to don and doff the orthoses, get up and down stairs and curbs, or wall; on a Rat surface, Subjects required significantly more assistance when using the WO to walk over inclined surfaces (medi an IRGO = ''independent,'' median WO = ''minimal assistance''; p = .03 ) but less assistance when using the WO to get from sitting to standin g and standing to sitting (median IRGO = ''moderate assistance,'' medi an WO = ''minimal assistance''; p = .03). In addition, subjects walked significantly faster with the IRGO both on the flat (mean IRGO = .34 m/sec +/- .18, mean WO = .14 m/sec +/- .12; p = .002) and on inclined surfaces. Conclusions: Although it is easier to stand up and sit down with the WO, the IRGO facilitated a faster and more independent gait. Neither orthosis enabled subjects to be fully independent in the key s kills necessary for functional ambulation after 8 weeks of training. ( C) 1997 by the American Congress of Rehabilitation Medicine and the Am erican Academy of Physical Medicine and Rehabilitation.