Ambulation with the reciprocating-gait orthosis - Experience in 15 children with myelomeningocele or paraplegia

We reviewed 15 children with spina bifida or paraplegia who have used a reciprocating-gait orthosis between 1985 and 1995. All were nonfunctional ambulators. The level of the spinal lesions ranged from Th10 to L3. The mean age of fitting the orthosis was 5 years. 8 children have stopped using it at an average age of 10 years. The maximum ambulation level with the orthosis was a community ambulator in 4 children, household ambulator in 9 children and 2 remained nonfunctional ambulators. The average daily use was 6 hours by community ambulators to 0.5 hours nonfunctional ambulators. Bilateral dislocations of the hip, mild flexion deformities of the hips and knees and scoliosis were well tolerated with orthotic wear. Since functional ambulation could be achieved in 6 children with no quadriceps power, the use of this orthosis can be advocated for upper lumbar and low thoracic lesions. Strong motivation, realistic goals and expectations, the ability to participate in a training program and journeys for frequent orthosis repairs are of importance for successful use of this orthosis.