A Reciprocating Gait Orthosis, or RGO, is a specialized mobility aid designed to help individuals who experience lower limb weakness or paralysis. This custom-fitted, wearable device provides support and stability to the lower limbs, enabling users to achieve a more natural walking pattern. It offers a pathway to increased independence and mobility for those who might otherwise rely on wheelchairs or other assistive devices.
Understanding the RGO Orthotic
An RGO orthotic is an orthopedic device crafted to enable standing and walking for individuals with compromised lower limb function. This custom-fabricated brace is tailored to each user’s specific measurements and physical needs. It typically consists of bilateral knee-ankle-foot orthoses (KAFOs) or ankle-foot orthoses (AFOs) connected to a pelvic section with a specialized reciprocating mechanism.
The structure includes jointed metal frames, straps, and components that securely attach to the wearer’s legs and torso. These components feature hip, knee, and ankle joints, which are interconnected by a system of hinges, locks, and cables or rods. Advanced RGO designs incorporate materials like carbon fiber, making them lighter and more comfortable than older, heavier models.
How RGO Orthotics Facilitate Movement
The core mechanism of an RGO orthotic lies in its ability to facilitate a reciprocal gait. This means that the device coordinates the movement of both legs, allowing one leg to move forward as the other moves backward, mimicking a natural walking motion. The hip dual-cable mechanism is central to this action; hip extension on one leg assists with hip flexion on the opposite leg.
When the user shifts weight onto one leg and leans slightly backward, the rigid torso support forces the non-weight-bearing leg to extend. As the user shifts weight to this extended leg with forward momentum, the extended leg rotates about the torso joint into a flexed position, initiating the next step. This synchronized movement, facilitated by a pivot joint and a spring-loaded hip hinge, creates an energy-efficient gait and reduces the effort for walking.
Common Conditions Where RGOs are Used
RGOs are commonly prescribed for individuals with conditions that cause paralysis or significant weakness in the lower limbs and trunk. Spinal cord injuries, especially those resulting in paraplegia, are a frequent indication for RGO use.
Spina bifida, a congenital condition affecting the spinal column, is another common diagnosis where RGOs are beneficial, particularly for children. Other neurological conditions, such as cerebral palsy, muscular dystrophy, stroke (hemiplegia), and Guillain-Barré syndrome, may also warrant the use of an RGO to assist with mobility and walking stability.
Getting and Living with an RGO Orthotic
Obtaining an RGO orthotic begins with a thorough assessment by a multidisciplinary team. This team typically includes a physician, an orthotist who specializes in designing and fitting braces, and a physical therapist. They evaluate the patient’s specific needs, neurosegmental level, overall body weight, and the degree of any existing contractures or deformities in the lower limbs.
Following the assessment, the RGO is custom-fabricated based on individual measurements. Once the orthotic is ready, a fitting and adjustment phase takes place to ensure proper fit and function. Physical therapy training is then required to teach the user how to effectively use the device, including initiating steps through weight shifting and utilizing assistive devices like crutches or a walker for balance. Daily considerations for RGO users include learning proper techniques for donning and doffing the orthosis, routine maintenance, and understanding that periodic adjustments may be needed as the user’s body changes.