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; 9 years 11 months SD 2 years 7 months; 18 sacral, 9 low lumbar, 20 mid-high lumbar) and seven children with typical development (5 males; 11 years 1 month SD 1 year 11 months) 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.

Implications for Rehabilitation

• Obesity, muscle weakening and disuse osteoporosis are issues for those with myelomeningocele, all of which are affected by walking activity.

• Understanding walking activity and intensity in children and adolescents with myelomeningocele may aid in developing focused rehabilitation interventions and strategies.

• Real world walking activity as an objective and quantified measure has the potential to help guide therapists and surgeons to more effective treatments.

Keywords:

• Myelomeningocele
• pedometer
• spina bifida
• walking activity

Disclosure statement

The agencies were not involved in study design, data collection, data analysis, manuscript preparation and/or publication decisions. The authors report no conflicts of interest.

Funding information

This study was supported by NIH-NICHD (Grant # 5R01HD059826) from the National Institutes of Health – Eunice Kennedy Shriver National Institute of Child Health and Human Development.