The functional use of the reciprocal hip mechanism during gait for paraplegic patients walking in the Louisiana State University reciprocating gait orthosis

Abstract

Reciprocally linked orthoses used for paraplegic walking have some form of linkage between the two hip joints. It has been assumed that flexion of the swinging leg is driven by extension of the stance leg. The aims of this study were to investigate the moments generated around the hip joint by the two cables in a Louisiana State University Reciprocating Gait Orthosis (LSU-RGO). Six (6) subjects were recruited from the Regional Spinal Injuries Centre at Southport, who were experienced RGO users. The cables were fitted with strain gauged transducers to measure cable tension. Foot switches were used to divide the gait into swing and stance phases. A minimum of 20 steps were analysed for each subject. Moments about the hip joint for each phase of gait were calculated. There were no moments generated by the front cable in 4 of the subjects. In only 2 subjects did the cable generate a moment that could assist hip flexion during the swing phase. These moments were very low and at best could only have made a small contribution to limb flexion. The back cable generated moments that clearly prevented bilateral flexion. It was concluded that the front cable, as used by these experienced RGO users, did not aid flexion of the swinging limb.

Effect of Orthotic Gait Training with Isocentric Reciprocating Gait Orthosis on Walking in Children with Myelomeningocele

“…Dall et al reported that the reciprocal link has a minimal effect on leg swing. 37 In the present study, at baseline, the compensatory motions were high when walking with the IRGO, but a significant improvement in these parameters was found after 8 weeks of gait training. The children with MMC used their trunk muscles to ambulate with the IRGO.…”

“…36 Dall et al suggested that the reciprocal link is minimally important in leg swing when RGOs were used for walking in paraplegic patients. 37 In addition Johnson et al demonstrated that the use of orthoses and assistive devices alone has limited effects on the improvement walking parameters in children with MMC. In the paraplegic patients, trunk and pelvis motion contributes more to leg swing than elements of the orthosis such as the reciprocal link in the ARGO and IRGO.…”

Trunk muscle activity patterns in a person with spinal cord injury walking with different un-powered exoskeletons: A case study

“…Compared with the ES-EXO (w), a lack of pelvic shell caused a large rotation range of the trunk and pelvis, which probably required greater muscle force. In the IRGO condition, hip flexion was driven by contralateral hip extension through the reciprocal rocking pelvic band (9). Users usually adopt a flexed trunk posture to ensure stability through increasing the area of support created by the feet and the walker (7).…”

Orthoses for Spinal Cord Injury Patients

“…The energy consumption of using RGOs reported low rate compared to other mechanical orthoses such as MLOs and HKAFOs, based on the reciprocal section of RGOs announced as the responsible for this result. But the effect of the reciprocal link in providing of the reciprocal motion was demonstrated less [62][63][64]. Using RGOs for SCI patients rather than MLOs is cumbersome due to their bulky structure and using an MLO has high energy consumption compared to RGOs, but MLOs are more user-friendly for people with SCI [15,65].…”