A Reciprocating Gait Orthosis, often referred to as an RGO, is a specialized orthopedic device designed to help individuals with lower limb weakness or paralysis achieve a more natural walking pattern. This brace provides external support and facilitates movement, allowing users to stand and walk with assistance. It serves as a sophisticated tool for enhancing mobility and promoting greater independence for those facing significant physical challenges.
How a Reciprocating Gait Orthosis Works
An RGO operates on a principle of reciprocal motion, coordinating the movement of both legs to mimic a natural walking stride. It consists of jointed metal frames, straps, and components that attach to the wearer’s legs and torso. These often include bilateral knee-ankle-foot orthoses (KAFOs) or ankle-foot orthoses (AFOs) connected to a pelvic section.
The RGO’s reciprocating mechanism, often involving cables or bars linking the hip joints, is central to its function. When one hip extends, the mechanism facilitates flexion in the opposite hip, allowing that leg to swing forward. This coordinated movement, initiated by the user through weight shifting or assistive devices like crutches, converts trunk motion into a controlled stepping pattern. The design includes hinges at the hip and knee joints for dynamic movement and a locking mechanism that provides stability when standing or resting. This mechanical coupling enables a more energy-efficient gait by leveraging existing body movements to propel the legs.
Conditions That Benefit from an RGO
RGOs are prescribed for individuals with lower limb paralysis or significant weakness. These often involve spinal cord damage or neurological impairments affecting muscle control. Examples include spinal cord injuries (especially above L1) and spina bifida, a congenital condition impacting spinal development.
The RGO also benefits individuals with cerebral palsy, a group of disorders affecting movement and muscle tone, by assisting with walking stability. Stroke survivors with hemiplegia (weakness on one side of the body) may also find improved mobility with an RGO. Muscular dystrophy and traumatic brain injuries, depending on lower limb involvement, can also indicate RGO use. Successful use requires good upper body strength, minimal lower limb contractures, and the ability to use walking aids.
Advantages of Using an RGO
Using an RGO offers several benefits for individuals with lower limb mobility impairments. A primary advantage is improved gait, as the device facilitates a more natural, alternating leg movement. This coordinated reciprocal action contributes to a smoother and more efficient walking experience.
The RGO also enhances stability and provides support, with its jointed structure and locking mechanisms reducing fall risk. This increased stability often translates to greater independence, as users can perform daily activities with less reliance on caregivers or wheelchairs. Beyond direct mobility, regular standing and walking in an RGO can help maintain muscle function, improve circulation, and promote bone density, potentially lessening the risk of complications like pressure sores. The ability to stand at eye level and engage in upright activities also offers psychological and social benefits, contributing to an improved quality of life.
The Journey of Obtaining and Adapting to an RGO
Obtaining and adapting to an RGO involves a comprehensive, multi-stage journey requiring a dedicated team of healthcare professionals. This team often includes doctors, orthotists, and physical therapists working to ensure the best outcome. The initial phase involves a thorough assessment by a specialist to determine RGO appropriateness, considering factors like the patient’s neurosegmental level, body weight, and upper limb strength.
Once deemed suitable, precise custom measurements are taken to fabricate the RGO, ensuring an individualized and comfortable fit. Modern RGOs, sometimes incorporating materials like carbon fiber, are designed to be lighter and more comfortable than older models.
Following fabrication and initial fitting, extensive physical therapy and training are necessary for the user to operate the device effectively. This training progresses from static standing to reciprocal stepping within parallel bars, and eventually to overground ambulation with assistive devices like forearm crutches or a walker. Consistent practice is required to master the weight-shifting techniques that drive the reciprocal motion. Ongoing adjustments and maintenance of the orthosis are also part of the long-term journey to ensure optimal function and user comfort.