A hip-knee-ankle-foot orthosis (HKAFO) consists of a trunk section connected to two KAFOs by two lateral hip joints. These joints usually have locks that can be disengaged for sitting. Movement with an HKAFO is achieved by a swing through or hopping type gait with the assistance of either a walker or forearm crutches with both legs are moved together as one unit.

A reciprocating gait orthosis (RGO) is also a HKAFO however it allows one leg to be placed ahead of another - more like normal walking. This is achieved by linking the two KAFOs together by a band, two cables or a push-pull rod which transfers movement energy from one leg to the other (see diagram). Therefore as one leg is flexed or brought forward, it causes a reciprocal extension of the other leg. This allows a much smoother gait and greatly reduces the amount of effort that is needed to walk. A walker can often be abandoned for forearm crutches.

RGOs tend to be most successfully used for children with spina bifida starting as young as 2.5 years old but have been used by children with other diagnoses. RGOs are sometimes used for adult paraplegics but often a wheelchair becomes the preferred mode of transportation for the adults.

The RGO is commonly used for individuals with a lesion level of T12 to L3 (although higher levels are possible) who lack adequate strength to maintain hip extension. Good upper extremity strength, high motivation levels, good family support and minimal contractures definately contribute to the successful use of the device.