Ambulation of children with myelomeningocele: parapodium versus parapodium with Orlau swivel modification.
The feasibility of ambulation for children with high spinal lesions is questionable because of the relatively high exercise intensity and energy cost required, so orthotics designed for ambulation must keep energy expenditure to a minimum. This study determined the self-selected walking velocity and maximum walking velocity of 10 paraplegic children using two orthotic devices, the parapodium and swivel walker, and compared the energy cost, gait efficiency and relative exercise intensity (per cent maximum heart-rate). Walking velocities were significantly higher with the parapodium, but energy cost and gait efficiency were significantly better with the swivel walker. Differences between the two devices in relative exercise intensity were not significant. Although walking velocity is slower, the lower metabolic cost appears to give the swivel walker an advantage over the parapodium.