Abstract

Rear support walking frames provide predetermined vertical support for patients with dysfunctional lower limbs that have limited active control; the support is provided through a spring-loaded boom hinged on an upright stanchion mounted at the rear of a wheeled frame within which the patient ambulates. The application of these frames for total-body-involved cerebral palsy patients, in combination with a walking orthosis, has highlighted a number of practical problems that need to be addressed for the system to become fully viable. A composite material prototype walking frame has been developed that permits the patient to be transferred by a single carer without the need to use inappropriate manual handling techniques. The frame has improved structural properties, with stiffness in the sagittal and coronal planes increasing by between 50 and 100 per cent. Evaluation with patients showed that the greater structural stiffness permitted the objective of improved continuity of walking to be achieved. The strength of the frame is such that it can accommodate patients of up to 80 kg, more than twice that possible in the earlier system. Since the structural yield point is approximately twice the maximum working load, the device should not be prone to unacceptable fatigue characteristics. Despite the use of carbon composite materials (which have brittle failure characteristics), the mode of failure is of progressive collapse and is therefore inherently safe. The successful outcome of prototype testing has justified production development. Work is now proceeding on a design that incorporates further improvements in structural performance and ease of manufacture.

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