High-tech rehab research goes mobile.

High-tech rehab research goes mobile

Researchers are optimistic about recent, experimental improvements in an orthopedic device that allows paraplegics to assume upright posture and a nearly normal walk with only the help of a walker. The Reciprocal Gait Orthosis (RGO), developed by researchers at Louisiana State University Medical Center in New Orleans and gradually improved by them over the past 10 years, is a hip and leg brace with a system of cables that allows an otherwise wheelchair-bound patient to stand and perform reciprocal leg extension and flexion -- the coordinated left and right "stepping" action of walking. The patient provides the energy for upper leg movement, while the brace provides structural support and coordinates the reciprocal action. With the aid of a walker or crutches, these patients can, with some effort, walk and even climb stairs.

In a recent improvement of the RGO, Moshe Solomonow and his co-workers at Louisiana State university added a four-channel electrical-stimulation unit that allows a patient to manually contract the contralateral quadriceps and hamstring muscles in the legs for more graceful, effective and energy-efficient movement while using the walker. Hand-operated switches on the walker handles allow the patient to stimulate each leg electrically to extend and flex. Preliminary data suggest the energy expenditure of walking is reduced as much as 50 percent in comparison to values for the RGO without electrical stimulation. Muscle atrophy from disuse is also apparently reversed after only six weeks of use, and circulation seems improved.

Solomonow says one of his highly motivated patients can already do something resembling "the Michael Jackson space-walk, walking backwards." This is "not something to giggle at," he adds, reminding the more mobile among us that the ability to maneuver backwards is a great advantage, especially in small spaces such as bathrooms.