Clinical Evaluation of Spina Bifida Patients Using Hip Guidance Orthosis

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Abstract
A hip guidance orthosis was designed to provide the highest potential level of ambulation for the child with myelomeningocele. It permits low energy-cost ambulation at a reasonable speed, and independent transfer from chair to walking and vice versa. It also enables some patients to ascend or descend steps of up to 150mm and gradients of up to 1 in 10. A review of 27 patients who had used the orthosis for periods of between 6-45 mo. was undertaken to establish the degree of benefit. Of these, 17 patients had no power in hips or below, the rest having some power in 1 or both hips; 17 patients had dorsal lesions and the remainder had lumbar lesions. Using Hoffer''s classification, 13 patients had improved ambulation when using the hip guidance orthosis, and most of the remainder showed some measurable improvement in ambulation. Speed of ambulation and heart rate were tested in 14 patients before and after use of the orthosis, and the mean increase in speed was 87.3% with a mean decrease in heart rate of 10bpm[beats/min].sbd.a clear improvement in efficiency. The hip guidance orthosis can apparently provide low-energy ambulation for spina bifida patients with dorsal and high lumbar lesions in a form acceptable both to patients and parents.

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