Prescribing the reciprocal gait orthosis for myelomeningocele children: a different approach and clinical outcome.
The reciprocal gait orthosis (RGO) is a recognized mobility aid for lower thoracic-upper lumbar paraplegia. However, criteria exist that limit prescription in the myelomeningocele (MMC) population. At the Alyn Rehabilitation Hospital, every child with MMC is offered a programme of ambulation with a used but adjusted RGO. Only those children with a positive outcome (those who achieve a minimum of 10 strides on repeated occasions) then receive their own RGO. Seventy patients with MMC, neurological level L3 and cephalad entered the programme over the period 1988-1998. Forty-nine (70%) of the children were successful and received their own RGO; success correlated inversely with the neurological level and correlated directly with parental cooperation (OR = 9.4). The period of use related positively with availability of a treatment centre. This pre-prescription clinical approach reveals those children who can achieve ambulation contrary to stated criteria, while saving unnecessary costs in those failing the test trial.
Katz-Leurer
Michal
M
Alyn Hospital, Pediatric and Adolescent Rehabilitation Center, Kiryat Yovel, Jerusalm, Israel.
Weber
Coos
C
Smerling-Kerem
Julie
J
Rottem
Hemda
H
Meyer
Shirley
S
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007557:Israel; D016015:Logistic Models; D008297:Male; D008591:Meningomyelocele / Q000534:rehabilitation*; D009989:Orthotic Devices; D017063:Outcome Assessment, Health Care; D010264:Paraplegia / Q000534:rehabilitation*