The parapodium: an orthotic device for neuromuscular disorders.

Some of the serious shortcomings of the standard brace for young patients with paralysis of the lower extremities are the lack of adjustability to accommodate growth and contractures, excessive weight, in¬ stability, difficulty in locking and unlocking, and the t ime required for donning and re¬ moval. The Parapodium (3) was designed in the effort to introduce a modular system that offers alternatives and resolves some of those difficulties. The Parapodium facilitates standing without crutches, thus freeing the patient 's hands for a wider range of activities. The difference between tripod standing and crutchless standing is a major distinction between our approach to brace design and that of conventional braces. This orthosis is best suited for patients with severe spina bifida or t raumatic para¬ plegia; however, it also may be prescribed for other neuromuscular disorders in which stability of the brace (permitting standing or swivelling without crutches), lightness of the device, and an upright position are important . Because of the modular design, growth in a child is easily accommodated. The foot¬ plate will accept several sizes of regular boots; there are four sizes of footplates for boots from 5 1/2 in. to 9 1/2 in. long. The height of the Parapodium can be adjusted by replacing the tubular sidebars with a longer piece of tubing, which is cut from