N. Roussos et al., A long-term review of severely disabled spina bifida patients using a reciprocal walking system, DISABIL REH, 23(6), 2001, pp. 239-244
Purpose : The purpose of the study was to establish long-term compliance of
paediatric spina bir da patients using a reciprocal walking orthosis, pres
cribed to enhance function and long-term therapeutic benefit.
Methods : Data from current clinical notes of 28 spina bir da patients pres
cribed with the Parawalker reciprocal walking orthosis between 1973 and 198
4 were compared with those established for the purposes of research at the
time of original prescription. Patients were supplied via an on-going treat
ment regime by a specialist multi-disciplinary team. Regular followup was a
n essential element of the clinical policy. This enabled effective monitori
ng of patient performance and requirements. It also ensured that accurate d
ata was maintained. Clinical and walking performance details were recorded
at the time of supply. Current clinical notes from routine follow-up review
s for patients in the study were scrutinized to establish present status, a
mbulation performance and medical history.
Results : Fourteen patients had thoracic lesions - the remainder having hig
h, mid lumbar or variably diagnosed lesions. The period of use ranged from
4.6 to 18.1 years (average = 9.71 years) The orthosis was first prescribed
at 3.6 years to 13.9 years. Discontinuation occurred at between 11.2 and 23
.9 years. None of the patients suffered a pressure sore or bone fracture.
Conclusions : Long-term continuation of reciprocal walking within a control
led treatment regime was established. This enabled confirmation that compre
hensive health care systems can achieve improvements in patient function, t
ogether with overall cost savings because of the reductions in pressure sor
es and bone fractures identified for such activity.