CHILDREN WITH SPINA BIFIDA

·         Treatment focus in children with Spina Bifida is to determine the extent of the symptoms and the development of disabilities.

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·         This also focuses on how to prevent those disabilities which can be prevented.

·         This requires the suitable and exact rehabilitation program and medical treatment which carry along the development of the child.

·         Positive attitude is mandatory for parents and clinical professionals to mange the situation for longer time. This will develop the positive outlook of the child.

 

FACTORS AFFECTING THE EVENTUAL AMBULATORY STATUS OF CHILDREN WITH SPINA BIFIDA

Factors which may affect the children with spina bifida and their treatment outcomes are:

(1) visual and motor perception impairment

(2) musculoskeletal deformity degree

(3) sensory impairment

(4) acquired obesity

(5) existing muscle strength

(6) neurological involvement level

 (7) patient motivation

 (8) family support

·         Level of the motor function and the functional mobility are the basic measures to achieve the certain degree of functional and ambulation capability.

·         It is needed to consider that the factors like

o   Contractures

o   Limited sitting balance

o   Obesity

may strongly effect the walking ability of child either with or without orthosis.

·         These factors along with the mother function level of child can toughly influence the effectiveness of the orthotic management

·         As this is a complex major birth defect so the orthotic management is challenging for orthosist.

·         A complete understanding of the Spina bifida can only develop the achievable and considerable goals.

·         This must be very clear to the family to understand the treatment process as well as role of the orthosis.

·         Following are the specific factors

                                 i.            hip disorders (e.g., dislocation, subluxation, contractures),

                                ii.            knee flexion/extension contractures,

                              iii.            foot/ankle deformities (e.g., equinovarus, clubfoot).

In such situations, the orthotic goal should be to prevent the deformity by maintain the appropriate alignment of joint to achieve reasonable muscle balance in development stage. This may result into proper weight bearing and movement.