Walking activity during daily living in children with myelomeningocele

Abstract

Purpose To quantify the walking activity of children with myelomeningocele during daily living. Method Walking activity was measured using a StepWatch activity monitor over one week in 47 children with myelomeningocele (27 males; 9y 11mo SD 2y 7mo; 18 sacral, 9 low lumbar, 20 mid-high lumbar) and 7 children with typical development (5 males; 11y 1mo SD 1y 11mo) in a prospective, cross-sectional study. Average total steps per day, number of steps and minutes spent at low, medium and high intensity stepping were evaluated. Groups were compared using t-tests and chi-squared tests with Bonferroni post-hoc adjustment. Results Children with sacral and low lumbar myelomeningocele exhibited no significant differences in demographic characteristics or walking performance compared to typically developing children. Children with mid-high lumbar myelomeningocele exhibited higher BMI percentile than the control group (p=0.04) and took fewer total steps per day than all other groups (p≤0.04). Children with mid-high lumbar myelomeningocele also spent significantly less time taking steps at all intensity levels, particularly medium-intensity, than the sacral and low lumbar groups (p≤0.04). Conclusions Children with sacral and low lumbar myelomeningocele had walking performance similar to typically developing children despite a common need for braces and assistive devices. Children with mid-high lumbar myelomeningocele were less active, which may lead to heightened risk for secondary health conditions in addition to those associated with myelomeningocele.

Independently ambulatory children with spina bifida experience near-typical joint moments and forces during walking

“…This group also exhibited typical numbers of daily loading cycles (steps per day). The daily steps recorded on activity monitors worn by participants with spina bifida (9656 [SD 3095] steps) were comparable to those previously reported from 7 children with typical development who underwent the same activity monitoring protocol (9589 [SD 3322] steps [34]). Our findings of near-typical joint forces and loading cycles, combined with the neartypical bone health observed (Table 1), suggest that maintaining ambulation and muscle strength can promote bone health in this group.…”

Relationships among classifications of impairment and measures of ambulatory function for children with spina bifida

“…The study showed that children with sacral and low lumbar level lesions (based on IMSG rating) function similarly to their typically developing peers, whereas those with mid-high lumbar lesions were less active. [22] The current study expands on the previous work by examining relationships among various classifications of neurosegmental and functional level, and their associations with actual ambulatory activity performance.…”

Children with myelomeningocele do not exhibit normal remodeling of tibia roundness with physical development

“…This suggests that the type of gait also likely contributes to shape differences. While children with sacral and low lumbar MM (higher functional level of MM) take a similar number of steps per day as TD children, and with a similar profile of low, medium, and high intensity walking [28], previous studies have found that children with all levels of MM exhibit kinematic [29,30,31] and kinetic [32] gait deviations compared to TD children. This suggests that for independently ambulatory children with MM, kinematic (and kinetic) deviations play a significant role in bone remodeling.…”