Swing-through vs. reciprocating gait patterns in patients with thoracic-level spina bifida

Area of Science:

• Orthotics and Biomechanics
• Pediatric Rehabilitation
• Neuromuscular Disorders

Background:

• Spina bifida presents significant challenges to ambulation, often requiring assistive devices.
• Conventional hip-knee-ankle-foot orthoses (HKAFOs) can limit natural gait patterns.
• Reciprocating gait orthoses (RGOs) offer an alternative approach to ambulation support.

Purpose of the Study:

• To compare the gait efficiency of a reciprocating gait pattern using an RGO versus a swing-through gait pattern with conventional HKAFOs.
• To evaluate the functional impact of RGOs on walking speed and stride length in patients with thoracic-level spina bifida.

Main Methods:

• Three patients with thoracic-level spina bifida were assessed in a gait laboratory.
• Gait analysis was performed while patients used conventional HKAFOs with a swing-through pattern.
• Subsequent analysis involved patients using an RGO with a reciprocating gait pattern.

Main Results:

• The reciprocating gait pattern demonstrated modest improvements in walking efficiency over the swing-through pattern.
• Average walking speed increased from 11.4 m/min (swing-through) to 16.2 m/min (reciprocating).
• Stride length increased from 0.31 m (swing-through) to 0.54 m (reciprocating).

Conclusions:

• RGOs offer potential benefits for improving walking in spina bifida patients.
• Current RGO hip joint limitations (flexion/extension only, no rotation) hinder optimal gait.
• Future RGO design modifications focusing on rotational hip movement are recommended to enhance walking ability.