Parawalking-replies
Tim Jarrott
Description
Collection
Title:
Parawalking-replies
Creator:
Tim Jarrott
Date:
4/28/2008
Text:
Thanks to all again, here are the collated replies:
I have a rgo style orthosis I have patented that would work very well for
this man. It is an independent leg movement orthosis or ILMO for short. I
just pt one on a 23 year old t-12 complete and she was able to stand
unassisted and after some adjustments was able to do a step gait with in one
hour of wearing she was walking back and forth in parallel bars her gait
training will most likely only be for a week. the more advanced users are
taught how to go up and down stairs transfer to there cars and all walk with
walkers. I would be happy to send you info and video if interested.
Have you seen the Walkabout attachment for para.s. I'ts a reciprocating
attachment connecting two KAFOs that keeps the legs in slight abduction. I
think it's even detachable when not abulating.
You can use the ARGO system for better results in an evaluation than typical
RGO set ups. I use them tens units to activate muscles via a walker with
remote access ports. This can provide documentation repets to establish
therapy routines. Funding maybe an issue. Message me for more info if you
like. I am in honduras but will return to the states soon. I have pics and
repets that can help.
Brian Moore CPO
Sent via BlackBerry by AT&T
Hi,
I think your best bet is probably the Isocentric RGO, but you could try
the Walkabout Orthosis (I think it may be called something else now.) It
avoids going above the hip - uses a mechanism between the thigh cuffs. I fit
a SCI patient whom I believe was T12 (it's been awhile) and he did very
well. I think the IRGO = better efficiency, but is much bulkier/more
involved, so if your patient can use the Walkabout effectively for his
purposes he may like it better.
I'd recommend you look into the Up and About System. I think it was
developed in Australia, by the way. It's distributed through Cascade here
in the States.
Hello Tim,
Based on the information, this gentleman can be a community ambulator with
an RGO and a very limited walker/mostly standing with advanced ground
reaction AFO's. The wheelchair will be used for all long distances.
I had a client with very similar profile, he was able to walk long distances
with a well built RGO. He used each system as a tool. He mostly wore his
AFO's and a wheelchair. He had a pickup truck with a shell on it. His
wheelchair was placed in the back, he was able to hold onto the truck and
walk around it. In a grocery store or a non-handicap bathroom, he was able
to standup and either grab something off the top shelf or walk into a small
bathroom holding onto what was available. He was able to walk into most
places in his RGO and stand handsfree to talk to someone eye to eye.
His RGO and AFO's were highly customized to increase rigidity into the
systems for security and efficiency reasons. Both systems were designed to
be donned and doffed in his wheelchair. He utilized forearm crutches when
walking for balance. All standing was handsfree to accomplish tasks.
His grade two hip flexors will assist in leg advancement, the RGO is ideal
to support a hip with very weak hip extensors for ambulation. He should be
able to walk at a decent pace with the RGO. Even the AFO's, he was able to
walk short distances and stand hands free while talking to someone or to
rest. The AFO's took much more energy to walk and was much slower. Ideal
for wheeling to a location and standing up to accomplish a task.
I would recommend that he uses his arms for balance purposes and not for
walking on. All designs should maximize weight through his legs and
minimize arm usage. His long term independence depends on him saving his
arms, not over using them.
Good luck with this interesting case and you may contact me if you have any
questions.
Tim:
I would suggest that you contact the Miami Project to Cure Paralysis. They
have an on-going research program and the resource that I have used in the
past is Edele C. Field-Forte, Phd, PT.
She is extremely helpful and very giving of her time. When I first called
her, she spoke to me for about forty minutes and was very knowledgeable. I
had been given he name by another therapist in the community whom she did
not know, he knew of her by reputation. You can access their site at
miamiproject.miami.edu. and there is a contact us page.
Good luck
First good luck.
I have fit many RGO fro the Ico centric. It has a swivel bar, and does not
use the cable. I founf that the cable are to bulky and patient compliance
was lower with them. Patient compliance is better with the Iso-centric.
Here. I copied and pasted the info from thier web site.
www.centerfororthoticdesign.com. Once again, I hope thta this helps
Lead Orthotist
I have found the walkabout orthosis works exceptionally well in these
cases. No need to cross the hip. Easy donning and doffing also. Donning
is a big concern. If you google walkabout you'll find some examples. Hope
this helps. Pretty easy to fab in-house too.
Good Day Tim,
You are correct in your considerations about the Reciprocating Gait Orthosis
(RGO). The benefits of not only bone density maintenance, maintaining ROM of
the hip joints, intestinal functions and bladder drainage is better when up
vs. in a chair. Not to mention the scoio-psychological benefits of peer
standing and conversing. It sounds as if this gent may be an excellent
candidate for an RGO. The Fillauer COD IRGO is indicated for adults, and can
be attached to your choice of knee and ankle joints.
Fillauer has a CD of various options, kits or completed units available. If
this is something of interest to you, would you provide your mailing address
and I will ask the support staff to send you some literature to better
assist your clinic team in their prescription decision making.
Go to wearable therapy.com Contact Phil Muccio, CPO. He fit Christopher
Reeves. Hope this is an option for you. Good luck.
Sent by Good Messaging (www.good.com < <URL Redacted>> )
Hi Tim,
I'm not sure if this would be helpful to you, but I would consider this
brace for the individual you are seeing.
<URL Redacted>
I think with his activity level, surprising core strength, and ability, as
well as his goals, this would be the best choice for him.
Take good care,
Jen
Hi Tim
Have a look at the Para-Podium from a Polish company called Medort, it may
offer you and your patient an alternative.
Hi
I am afraid that i don't have any useful suggestions but would appreciate it
if you would post all advice give. I have a similar case.
Many thanks
sent you an article about some interesting combinations that Keith Smith CO
from St. Louis has done with a T10 SCI. The video is amazing if you can find
it. Basically, it's an LSO-RGO-KAFO with Horton Stance Control knee joints.
Pretty amazing.
Good Luck.
Tim Jarrott
Head to Foot Orthotics
16 / 100 New St
Ringwood VIC 3134
Australia
Ph: + 61 3 9876 0068
Fax: + 61 3 9870 0248
Mobile: 0413 628 117
E-mail: <mailto:<Email Address Redacted>> <Email Address Redacted>
Web: < <URL Redacted>> http://www.htforthotics.com.au
I have a rgo style orthosis I have patented that would work very well for
this man. It is an independent leg movement orthosis or ILMO for short. I
just pt one on a 23 year old t-12 complete and she was able to stand
unassisted and after some adjustments was able to do a step gait with in one
hour of wearing she was walking back and forth in parallel bars her gait
training will most likely only be for a week. the more advanced users are
taught how to go up and down stairs transfer to there cars and all walk with
walkers. I would be happy to send you info and video if interested.
Have you seen the Walkabout attachment for para.s. I'ts a reciprocating
attachment connecting two KAFOs that keeps the legs in slight abduction. I
think it's even detachable when not abulating.
You can use the ARGO system for better results in an evaluation than typical
RGO set ups. I use them tens units to activate muscles via a walker with
remote access ports. This can provide documentation repets to establish
therapy routines. Funding maybe an issue. Message me for more info if you
like. I am in honduras but will return to the states soon. I have pics and
repets that can help.
Brian Moore CPO
Sent via BlackBerry by AT&T
Hi,
I think your best bet is probably the Isocentric RGO, but you could try
the Walkabout Orthosis (I think it may be called something else now.) It
avoids going above the hip - uses a mechanism between the thigh cuffs. I fit
a SCI patient whom I believe was T12 (it's been awhile) and he did very
well. I think the IRGO = better efficiency, but is much bulkier/more
involved, so if your patient can use the Walkabout effectively for his
purposes he may like it better.
I'd recommend you look into the Up and About System. I think it was
developed in Australia, by the way. It's distributed through Cascade here
in the States.
Hello Tim,
Based on the information, this gentleman can be a community ambulator with
an RGO and a very limited walker/mostly standing with advanced ground
reaction AFO's. The wheelchair will be used for all long distances.
I had a client with very similar profile, he was able to walk long distances
with a well built RGO. He used each system as a tool. He mostly wore his
AFO's and a wheelchair. He had a pickup truck with a shell on it. His
wheelchair was placed in the back, he was able to hold onto the truck and
walk around it. In a grocery store or a non-handicap bathroom, he was able
to standup and either grab something off the top shelf or walk into a small
bathroom holding onto what was available. He was able to walk into most
places in his RGO and stand handsfree to talk to someone eye to eye.
His RGO and AFO's were highly customized to increase rigidity into the
systems for security and efficiency reasons. Both systems were designed to
be donned and doffed in his wheelchair. He utilized forearm crutches when
walking for balance. All standing was handsfree to accomplish tasks.
His grade two hip flexors will assist in leg advancement, the RGO is ideal
to support a hip with very weak hip extensors for ambulation. He should be
able to walk at a decent pace with the RGO. Even the AFO's, he was able to
walk short distances and stand hands free while talking to someone or to
rest. The AFO's took much more energy to walk and was much slower. Ideal
for wheeling to a location and standing up to accomplish a task.
I would recommend that he uses his arms for balance purposes and not for
walking on. All designs should maximize weight through his legs and
minimize arm usage. His long term independence depends on him saving his
arms, not over using them.
Good luck with this interesting case and you may contact me if you have any
questions.
Tim:
I would suggest that you contact the Miami Project to Cure Paralysis. They
have an on-going research program and the resource that I have used in the
past is Edele C. Field-Forte, Phd, PT.
She is extremely helpful and very giving of her time. When I first called
her, she spoke to me for about forty minutes and was very knowledgeable. I
had been given he name by another therapist in the community whom she did
not know, he knew of her by reputation. You can access their site at
miamiproject.miami.edu. and there is a contact us page.
Good luck
First good luck.
I have fit many RGO fro the Ico centric. It has a swivel bar, and does not
use the cable. I founf that the cable are to bulky and patient compliance
was lower with them. Patient compliance is better with the Iso-centric.
Here. I copied and pasted the info from thier web site.
www.centerfororthoticdesign.com. Once again, I hope thta this helps
Lead Orthotist
I have found the walkabout orthosis works exceptionally well in these
cases. No need to cross the hip. Easy donning and doffing also. Donning
is a big concern. If you google walkabout you'll find some examples. Hope
this helps. Pretty easy to fab in-house too.
Good Day Tim,
You are correct in your considerations about the Reciprocating Gait Orthosis
(RGO). The benefits of not only bone density maintenance, maintaining ROM of
the hip joints, intestinal functions and bladder drainage is better when up
vs. in a chair. Not to mention the scoio-psychological benefits of peer
standing and conversing. It sounds as if this gent may be an excellent
candidate for an RGO. The Fillauer COD IRGO is indicated for adults, and can
be attached to your choice of knee and ankle joints.
Fillauer has a CD of various options, kits or completed units available. If
this is something of interest to you, would you provide your mailing address
and I will ask the support staff to send you some literature to better
assist your clinic team in their prescription decision making.
Go to wearable therapy.com Contact Phil Muccio, CPO. He fit Christopher
Reeves. Hope this is an option for you. Good luck.
Sent by Good Messaging (www.good.com < <URL Redacted>> )
Hi Tim,
I'm not sure if this would be helpful to you, but I would consider this
brace for the individual you are seeing.
<URL Redacted>
I think with his activity level, surprising core strength, and ability, as
well as his goals, this would be the best choice for him.
Take good care,
Jen
Hi Tim
Have a look at the Para-Podium from a Polish company called Medort, it may
offer you and your patient an alternative.
Hi
I am afraid that i don't have any useful suggestions but would appreciate it
if you would post all advice give. I have a similar case.
Many thanks
sent you an article about some interesting combinations that Keith Smith CO
from St. Louis has done with a T10 SCI. The video is amazing if you can find
it. Basically, it's an LSO-RGO-KAFO with Horton Stance Control knee joints.
Pretty amazing.
Good Luck.
Tim Jarrott
Head to Foot Orthotics
16 / 100 New St
Ringwood VIC 3134
Australia
Ph: + 61 3 9876 0068
Fax: + 61 3 9870 0248
Mobile: 0413 628 117
E-mail: <mailto:<Email Address Redacted>> <Email Address Redacted>
Web: < <URL Redacted>> http://www.htforthotics.com.au
Citation
Tim Jarrott, “Parawalking-replies,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/229218.
