Re: RGOs

Re: RGOs

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