Functional gait comparison between children with myelomeningocele: shunt versus no shunt. 2007

Simone Battibugli, and Nicholas Gryfakis, and Luciano Dias, and Claudia Kelp-Lenane, and Stephanie Figlioli, and Elizabeth Fitzgerald, and Nicole Hroma, and Roopa Seshadri, and Christine Sullivan
Motion Analysis Center, Children's Memorial Hospital, Chicago, Illinois 60614, USA.

The aim of this study was to compare functional gait differences between patients with myelomeningocele (MM) who have a ventriculoperitoneal shunt (VPS) with those who do not. Our analyses were adjusted for confounding by age, lesion level, orthotic use, and assistive device use. The Functional Mobility Scale (FMS) was used to compare the shunted group (n=98; 60 males, 38 females; mean age 10y 2mo [SD 3y 11mo]; 73 sacral/19 low lumber/six high lumbar lesion level) with the non-shunted group (n=63; 32 males, 31 females; mean age 9y 11mo [SD 3y 11mo]; 45 sacral/12 low lumber/six high lumbar lesion level). Participants with a shunt had lower FMS 500 and FMS 50 scores compared with participants without a shunt; hence the participants without a shunt were more independent in their ambulation at medium and longer distances. For a subset of participants who underwent a three-dimensional gait analysis, we also collected temporal-spatial gait parameters (velocity, cadence, and stride length). Our results show that participants with MM and no shunt who underwent gait analysis(11 males, 10 females; mean age 9y 6mo [SD 4y]; 15 sacral/6 low lumber/0 high lumbar lesion level) tend to walk at a significantly greater velocity and stride length as compared with those with a shunt (33 males, 18 females; mean age 10y [SD 4y]; 38 sacral/13 low lumber/zero high lumbar lesion level). These data allow the treatment team to present more specific information regarding functional ambulatory expectations to patients with MM and their families.

UI MeSH Term Description Entries
D008297 Male Males
D008591 Meningomyelocele Congenital, or rarely acquired, herniation of meningeal and spinal cord tissue through a bony defect in the vertebral column. The majority of these defects occur in the lumbosacral region. Clinical features include PARAPLEGIA, loss of sensation in the lower body, and incontinence. This condition may be associated with the ARNOLD-CHIARI MALFORMATION and HYDROCEPHALUS. (From Joynt, Clinical Neurology, 1992, Ch55, pp35-6) Myelocele,Myelomeningocele,Acquired Meningomyelocele,Myelomeningocele, Acquired,Acquired Meningomyeloceles,Acquired Myelomeningocele,Acquired Myelomeningoceles,Meningomyelocele, Acquired,Meningomyeloceles,Meningomyeloceles, Acquired,Myeloceles,Myelomeningoceles,Myelomeningoceles, Acquired
D009989 Orthotic Devices Apparatus used to support, align, or augment the functioning of parts of the body. Orthoses,Orthosis,Parapodium,Device, Orthotic,Devices, Orthotic,Orthose,Orthotic Device,Parapodiums
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012656 Self-Help Devices Devices, not affixed to the body, designed to help persons having musculoskeletal or neuromuscular disabilities to perform activities involving movement. Assistive Devices,Assistive Technology,Assistive Device,Assistive Technologies,Device, Assistive,Device, Self-Help,Devices, Assistive,Devices, Self-Help,Self Help Devices,Self-Help Device,Technologies, Assistive,Technology, Assistive
D012720 Severity of Illness Index Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder. Illness Index Severities,Illness Index Severity
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

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