Ambulation with parapodia and reciprocating gait orthoses in pediatric spinal cord injury

The use of parapodia and reciprocating gait orthoses (RGOs) was reviewed in 41 children and adolescents with spinal cord injuries. Compared with users of RGOs, users of parapodia were younger when injured and when the orthotic was first used, were more likely to be household ambulators and to have higher neurological levels, and were unlikely to continue their use of the parapodium after early school age. Hip contractures that required surgical releases or contributed to discontinuation of orthotic usage were present in six of 26 parapodium users and 12 of 22 RGO users. RGOs and parapodia have a limited but important role in management of pediatric spinal cord injury, and should be used in a developmentally based program responsive to the changing needs of children and adolescents.