CLINICAL-EVALUATION OF A NEW ORTHOSIS, THE WALKABOUT, FOR RESTORATIONOF FUNCTIONAL STANDING AND SHORT-DISTANCE MOBILITY IN SPINAL PARALYZED INDIVIDUALS

The Walkabout orthosis is a relatively new device for assisted standin g and mobility in spinal paralysed individuals, The design, with a med ially-mounted single-axis hinge joint linking two knee-ankle-foot orth oses, is quite different to other currently available orthoses which h ave laterally positioned hip joints such as the Reciprocal Gait Orthos is or Hip Guidance Orthosis. Twenty-five spinal cord injured patients were fitted and trained with the Walkabout orthosis and followed up re gularly for just under 2 years on average. Sixty percent of all the pa tients fitted have incorporated use of the Walkabout orthosis into the ir lifestyles. Maintenance of joint mobility and psychological benefit s were the most important outcomes of Walkabout usage. Loss of thoraco -lumbar mobility was found to be a limiting factor in successful use o f the Walkabout orthosis in patients without active hip flexion. Patie nt selection criteria should include demonstrated spinal stability wit hout significant deformity, controlled muscle spasm, less than 5 degre es of hip or knee flexion contracture, achievable neutral ankle positi on, mobility of the thoraco-lumbar spine into lateral flexion, good-up per limb strength, and motivation with realistic expectations.