Highlights
- •Steps per day in youth with spina bifida was best predicted by assistive device use.
- •Youth with spina bifida who use assistive devices walk less.
- •Older age, male sex, and higher body mass index correlated with fewer steps per day.
- •Reduced lower extremity strength also related to fewer steps per day.
Abstract
Objective
To assess the relationship between real-world walking activity in children and adolescents
with myelomeningocele (MMC) and gross measures of lower extremity strength, range
of motion, demographics, and medical history.
Design
Prospective study.
Setting
Participants recruited in outpatient clinics; data collected in a hospital-based motion
analysis laboratory and in the community.
Participants
Children and adolescents (N=52) with daily step count data available from a larger
study of ambulatory children and adolescents with MMC.
Interventions
Not applicable.
Main Outcome Measure
Univariate and multivariate regression was used to assess which participant characteristics
and clinical factors were related to average number of steps per day.
Results
Univariate analysis showed a lower number of steps per day correlated with older age,
male sex, higher body mass index, higher lesion level, use of assistive devices for
ambulation, history of shunt placement, more television (TV) watched per week, lower
hip extension and abduction strength, knee flexion strength, and ankle dorsiflexion
and plantarflexion strength, and decreased knee and hip range of motion. Only assistive
device usage and hours of TV watched per week remained in the final multivariate model
predicting number of steps per day.
Conclusions
Walking activity in children and adolescents with MMC was best predicted by assistive
device use and amount of sedentary activity. Other predictors of walking activity
from univariate analysis were related to assistive device use. This information can
help tailor rehabilitation efforts and educate patients and families. Interventions
targeting early prevention of strength loss and contractures may be important to retain
or increase walking activity in children and adolescents with MMC.
Keywords
List of abbreviations:
BMI (body mass index), HRQL (health-related quality of life), MMT (manual muscle testing), MMC (myelomeningocele), ROM (range of motion), TV (television)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 25, 2019
Footnotes
Supported by the National Institutes of Health – Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant no. 5R01HD059826).
Disclosures: none.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
