A 7 year retrospective review of 42 patients of 16 years or over using the ORLAU Parawalker has been conducted to establish the degree of long-term compliance in using the orthosis on a regular basis. Regular use was defined as putting the orthosis on at least once a week. All subjects had been supplied with an ORLAU Parawalker via the routine supply procedures adopted in Oswestry, and were followed up at regular 6 month intervals as part of the standard treatment regime. The records from routine follow-up were surveyed for those patients who were continuing to use their orthosis to establish age, length of time since supply of orthosis and cause of lesion. Average period of usage is calculated for those still using their orthosis, and for all patients in the study. Of the 42 subjects, 32 were myelomeningocele patients with confirmed absence of innervation of hip extensors and abductors, the remainder being paraplegic patients with traumatic or acquired complete thoracic lesions. Compliance figures were extracted from the results, as were the minimum possible average periods of usage. The respective results were: of the 32 myelomeningocele patients 59.4% continued usage after an average period of 85.5 months, and of the 10 traumatic or acquired lesion patients 60% continued usage after an average period of 24.8 months respectively, which gave a combined compliance of 59.5% after a minimum average 71.1 months of use. The performance or myelomeningocele patients suggests that their additional deformities do not lead to inferior compliance as adults and that a high proportion to continue to walk after adolescence.
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http://dx.doi.org/10.3109/03093649709164543 | DOI Listing |
Disabil Rehabil
April 2001
ORLAU, The Robert Jones & Agnes Hunt Orthopaedic and District Hospital NHS Trust, Oswestry, Shropshire, UK.
Purpose: The purpose of the study was to establish long-term compliance of paediatric spina bifida patients using a reciprocal walking orthosis, prescribed to enhance function and long-term therapeutic benefit.
Methods: Data from current clinical notes of 28 spina bifida patients prescribed with the Parawalker reciprocal walking orthosis between 1973 and 1984 were compared with those established for the purposes of research at the time of original prescription. Patients were supplied via an on-going treatment regime by a specialist multi-disciplinary team.
Spinal Cord
January 2000
Center of Sports Medicine, don C. Gnocchi Foundation, IRCCS, Milan, Italy.
Study Design: To study the energy cost of locomotion during ambulation with different orthoses (HIP Guidance Orthosis Orlau Parawalker (PW), n=4; Reciprocating Gait Orthosis (RGO), n=6; RGO + FNS, n=4).
Objectives: Since high energy costs of locomotion have been proposed as a major reason for early rejection of orthotic use, our aims were (a) to evaluate the impact of functional neuromuscular stimulation (FNS) on energy expenditure during orthosis-assisted ambulation; (b) to study whether energy expenditure data can predict the poor long-term patients' compliance and (c) to assess selection criteria for the assignment of the different types of orthosis.
Setting: The study was completed at the Center of Sports Medicine and Center of Bioengineering, don C.
Prosthet Orthot Int
August 1997
Department of Bioengineering, Newcastle General Hospital, UK.
A 7 year retrospective review of 42 patients of 16 years or over using the ORLAU Parawalker has been conducted to establish the degree of long-term compliance in using the orthosis on a regular basis. Regular use was defined as putting the orthosis on at least once a week. All subjects had been supplied with an ORLAU Parawalker via the routine supply procedures adopted in Oswestry, and were followed up at regular 6 month intervals as part of the standard treatment regime.
View Article and Find Full Text PDFEur J Pediatr Surg
December 1995
Orthotic Research and Locomotor Assessment Unit, Robert Jones and Agnes Hunt Hospital, Oswestry, Shropshire, UK.
There is a widely accepted perception that whereas many paediatric myelomeningocele patients use walking orthoses effectively, very few continue to ambulate in adult life. A seven-year retrospective review of 31 patients for whom the ORLAU ParaWalker (2) was prescribed in Oswestry showed that there was a 58% adult compliance rate. Of the 18 who continued walking the average age at supply was 11.
View Article and Find Full Text PDFClin Biomech (Bristol)
September 1993
Department of Bioengineering, Polytechnic of Milan, Milan, Italy; Bioengineering Centre, Fnd. Pro Juventute Don Gnocchi IRCCS, Milan, Italy.
Although good results have already been achieved in reciprocal walking for paraplegic patients using mechanical orthoses (e.g. ORLAU ParaWalker), improvements in lateral stiffness of walking devices could increase significantly the efficiency of ambulation.
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