Re: RGOs
Gary G. Bedard
Description
Collection
Title:
Re: RGOs
Creator:
Gary G. Bedard
Date:
3/15/1999
Text:
<Email Address Redacted> wrote:
>
> Thanks to all to e-mailed me on my inquiry regarding RGOs. I will pass along
> the responses to my colleague who is treating the patient. Here is a list of
> some of the responses:
> Paula-
> I've done a lot of RGOs over the years. I worked with Ron Cartaya, C.O. in
> Miami when I was in school at FL. International. In the time I worked with
> him we did appx. 75 RGOs. His phone # is 305 595 1370 and he could answer a
> lot of questions for you. He's a great teacher.
> Currently, I do 10-12 RGOs a year. From a fabrication standpoint, KAFOs are
> the biggest problem, I just can't seem to find anyone to do quality ones to
> be attached to a RGO. Fillauer has done some for me. Their dual cable system
> is nice for peds, but I question it for adults. I've been very disappointed
> on some of the recent KAFOs they've done for me. I think Wally Matloch at the
> Center for Orthotic Design in Redwood City, CA has some wonderfully intersting
> ideas. His Isocentric system is wonderful. He also uses external AFOs which
> are good, but are not for everyone. He would be another good choice to
> contact. Norcal in that same area of the country appears pretty good, but
> Itruly like the Isocentric RGO for adults.
> It sounds like your pt. may be a good candidate with his upper extremity
> strength. He should have active abdominals (sounds like he does) and be
> contracture free. The fabrication tips I would give you are these: Pull the
> KAFOs with the uprights under the plastic to increase strength. Solid, solid
> ankles---compcore or carbon-graphite additions are wise here , just be sure
> you have a good fit. Extendyour trimlines on the KAFOs as much as possible
> over the uprights to increase strength and rigidity. Most of my mistakes and
> mistakes I see from other practitioners have to do with weak braces
> (ankles,low trimlines,etc.) Hope this info helps. If I may be of further
> help, let me know. Josh Ryder, CO
> Fo
> rt Myers, FL
>
> have used the RGOs from the Center for Orthotic Design w/ great success. One
> of the biggest selling points for this particular model is that most patients
> can easily donn and doff it indepently. Another is that the energy
> expenditure costs less w/ this system than the cable types. The inventor
> Wallace M. Motloch, CO, BS, business address is:
> Center for Orthotics Design, Inc.
> 1629 Main St.
> Redwood City, CA 94063
> (650) 363-2722
> Good Luck, Steve Baum, CO, @ NovaCare of San Mateo, CA.
> Cascade Orthopaedic supply sells the Up & About system and they also loan a
> casting jig with video instruction. This system very well for up to a T10
> level injurie.
>
> Speak to Dave Parrot at 1800 888 0865.
>
> John Hattingh CP
>
> 'd suggest looking at the Parawalker especially if there is any
> spasticity at all, it is much more tolerant than an RGO. I have had some
> adults- even tall ones- succeed with Parawalker in doing some significnat
> excercise and even periodic community ambulation. Try contacting Horton's
> orthotics 501-663-2908 or via their website <URL Redacted>,
> or hunting for the ORLAU Parawalker info (it was a little hard to find for
> me, and I did not bookmark... ALso, there is another called Up and About
> with the joint in the midline that a few have preferred. Let me know if
> you cannot find that, I'll go look again...
>
> Vikki Stefans, pediatric physiatrist (rehab doc for kids) and working
> Mom of Sarah T. and Michael C., aka <Email Address Redacted>
> Arkansas Children's Hospital/ U of A for Medical Sciences, Little Rock
>
> Paul-
> Great topic for the posting;
> I think that you should start by gathering as much clinical info about your
> patient as you can, including social and demographic (like a history and
> physical). Then quickly proceed to a literature search that gives you some
> basis to form a suggestion on the type of treatment plan AND WHY!
> With that said I would like to share my experiences with a system that I have
> used for levels from T8 and distal.
> Cascade promotes it: it is called the UP AND ABOUT SYSTEM
> comes with casting frame and practitioner info as well as good patient info.
>
> Classify your patient-candidate well because this is where most failures
> happen.
> Good luck.
> Please post your responses and your results
>
> Paula,
> I have had good success with adults using two systems;
> 1) The Up & About by Cascade, you central fab it, it requires good
> use of upper extremities, and it isn't cheep.
> 2) The ARGO ( Liberty Technology), just uses an AFO with a lateral
> upright to the pelvic assembly.
> best of luck.....pkm
>
> work at TIRR hospital in Houston and we see a large population of patients
> with SCI. We have had great success using the ARGO. Our climate it is hot
> and humid. The lightweight open design is perfect for the patients. Because
> it is lightweight, it seems to improve energy expenditure. We are presenting
> a poster during the next ASIA (American Spinal Injury Assoc.) meeting on the
> ARGO. The orthotist who we work very closely with is Anne Pare her email
> address is <Email Address Redacted> There are some specific training needs particular to
> this RGO system over others. Let me know if you need more info.
>
> Sincerely,
> Teresa Cramer MS PT
> Thanks to all who wrote. I will post you on further developments.
> Sincerely, Paula Martinek
Dear Paula,
Thanks for posting the comments on your request for RGO information. I
saw the posting from Josh Ryder,CO in Florida suggested the use of
Compcore to reinforce the ankle area of the AFOs on the RGO.
The strongest reinforcement you can make is to insert bond the Compcore
reinforcement. This is a technique that we developed for the material
when one of our orthotist had a problem with a very large patient and
repeated failure with both conventional metal and plastic AFOs.
The ankle reinforcement coupon of Compcore is thermoformed in place
between two pieces of plastic. This is accomplished by cutting a backer
plate of polypropylene that is the same shape as the composite coupon.
The backer coupon should be enlarged approximately 1/4 in comparison to
the size of the composite coupone to accommodate shrinkage of the
plastic as it is heated.
The backer PP coupon and the Compcore coupon are placed in the oven with
the Compcore on the bottom of the stack. When the host sheet of PP and
the coupons are at molding temperatue, the stack is place on the model
first then the host sheet is formed. In thsi manner the Compcoure
reinforcement coupone becomes encapsulated by the backer PP coupon and
the host shee. The trial patient for this technique was over 260 pounds.
If you have further questions or if the central fab is not familar with
the technigue you can have them call me. (650)-349-0752. I developed
Compcore for Becker Orthopedic and run thermoforming courses all over
the country.
Sincerely,
Gary G. Bedard, CO, FAAOP
Technical Marketing Manger
Becker Orthopedic
(800) 521-2192
>
> Thanks to all to e-mailed me on my inquiry regarding RGOs. I will pass along
> the responses to my colleague who is treating the patient. Here is a list of
> some of the responses:
> Paula-
> I've done a lot of RGOs over the years. I worked with Ron Cartaya, C.O. in
> Miami when I was in school at FL. International. In the time I worked with
> him we did appx. 75 RGOs. His phone # is 305 595 1370 and he could answer a
> lot of questions for you. He's a great teacher.
> Currently, I do 10-12 RGOs a year. From a fabrication standpoint, KAFOs are
> the biggest problem, I just can't seem to find anyone to do quality ones to
> be attached to a RGO. Fillauer has done some for me. Their dual cable system
> is nice for peds, but I question it for adults. I've been very disappointed
> on some of the recent KAFOs they've done for me. I think Wally Matloch at the
> Center for Orthotic Design in Redwood City, CA has some wonderfully intersting
> ideas. His Isocentric system is wonderful. He also uses external AFOs which
> are good, but are not for everyone. He would be another good choice to
> contact. Norcal in that same area of the country appears pretty good, but
> Itruly like the Isocentric RGO for adults.
> It sounds like your pt. may be a good candidate with his upper extremity
> strength. He should have active abdominals (sounds like he does) and be
> contracture free. The fabrication tips I would give you are these: Pull the
> KAFOs with the uprights under the plastic to increase strength. Solid, solid
> ankles---compcore or carbon-graphite additions are wise here , just be sure
> you have a good fit. Extendyour trimlines on the KAFOs as much as possible
> over the uprights to increase strength and rigidity. Most of my mistakes and
> mistakes I see from other practitioners have to do with weak braces
> (ankles,low trimlines,etc.) Hope this info helps. If I may be of further
> help, let me know. Josh Ryder, CO
> Fo
> rt Myers, FL
>
> have used the RGOs from the Center for Orthotic Design w/ great success. One
> of the biggest selling points for this particular model is that most patients
> can easily donn and doff it indepently. Another is that the energy
> expenditure costs less w/ this system than the cable types. The inventor
> Wallace M. Motloch, CO, BS, business address is:
> Center for Orthotics Design, Inc.
> 1629 Main St.
> Redwood City, CA 94063
> (650) 363-2722
> Good Luck, Steve Baum, CO, @ NovaCare of San Mateo, CA.
> Cascade Orthopaedic supply sells the Up & About system and they also loan a
> casting jig with video instruction. This system very well for up to a T10
> level injurie.
>
> Speak to Dave Parrot at 1800 888 0865.
>
> John Hattingh CP
>
> 'd suggest looking at the Parawalker especially if there is any
> spasticity at all, it is much more tolerant than an RGO. I have had some
> adults- even tall ones- succeed with Parawalker in doing some significnat
> excercise and even periodic community ambulation. Try contacting Horton's
> orthotics 501-663-2908 or via their website <URL Redacted>,
> or hunting for the ORLAU Parawalker info (it was a little hard to find for
> me, and I did not bookmark... ALso, there is another called Up and About
> with the joint in the midline that a few have preferred. Let me know if
> you cannot find that, I'll go look again...
>
> Vikki Stefans, pediatric physiatrist (rehab doc for kids) and working
> Mom of Sarah T. and Michael C., aka <Email Address Redacted>
> Arkansas Children's Hospital/ U of A for Medical Sciences, Little Rock
>
> Paul-
> Great topic for the posting;
> I think that you should start by gathering as much clinical info about your
> patient as you can, including social and demographic (like a history and
> physical). Then quickly proceed to a literature search that gives you some
> basis to form a suggestion on the type of treatment plan AND WHY!
> With that said I would like to share my experiences with a system that I have
> used for levels from T8 and distal.
> Cascade promotes it: it is called the UP AND ABOUT SYSTEM
> comes with casting frame and practitioner info as well as good patient info.
>
> Classify your patient-candidate well because this is where most failures
> happen.
> Good luck.
> Please post your responses and your results
>
> Paula,
> I have had good success with adults using two systems;
> 1) The Up & About by Cascade, you central fab it, it requires good
> use of upper extremities, and it isn't cheep.
> 2) The ARGO ( Liberty Technology), just uses an AFO with a lateral
> upright to the pelvic assembly.
> best of luck.....pkm
>
> work at TIRR hospital in Houston and we see a large population of patients
> with SCI. We have had great success using the ARGO. Our climate it is hot
> and humid. The lightweight open design is perfect for the patients. Because
> it is lightweight, it seems to improve energy expenditure. We are presenting
> a poster during the next ASIA (American Spinal Injury Assoc.) meeting on the
> ARGO. The orthotist who we work very closely with is Anne Pare her email
> address is <Email Address Redacted> There are some specific training needs particular to
> this RGO system over others. Let me know if you need more info.
>
> Sincerely,
> Teresa Cramer MS PT
> Thanks to all who wrote. I will post you on further developments.
> Sincerely, Paula Martinek
Dear Paula,
Thanks for posting the comments on your request for RGO information. I
saw the posting from Josh Ryder,CO in Florida suggested the use of
Compcore to reinforce the ankle area of the AFOs on the RGO.
The strongest reinforcement you can make is to insert bond the Compcore
reinforcement. This is a technique that we developed for the material
when one of our orthotist had a problem with a very large patient and
repeated failure with both conventional metal and plastic AFOs.
The ankle reinforcement coupon of Compcore is thermoformed in place
between two pieces of plastic. This is accomplished by cutting a backer
plate of polypropylene that is the same shape as the composite coupon.
The backer coupon should be enlarged approximately 1/4 in comparison to
the size of the composite coupone to accommodate shrinkage of the
plastic as it is heated.
The backer PP coupon and the Compcore coupon are placed in the oven with
the Compcore on the bottom of the stack. When the host sheet of PP and
the coupons are at molding temperatue, the stack is place on the model
first then the host sheet is formed. In thsi manner the Compcoure
reinforcement coupone becomes encapsulated by the backer PP coupon and
the host shee. The trial patient for this technique was over 260 pounds.
If you have further questions or if the central fab is not familar with
the technigue you can have them call me. (650)-349-0752. I developed
Compcore for Becker Orthopedic and run thermoforming courses all over
the country.
Sincerely,
Gary G. Bedard, CO, FAAOP
Technical Marketing Manger
Becker Orthopedic
(800) 521-2192
Citation
Gary G. Bedard, “Re: RGOs,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 8, 2024, https://library.drfop.org/items/show/211353.
