Date of Award

1993

Document Type

Scholarly Project

Degree Name

Master of Physical Therapy (MPT)

Department

Physical Therapy

First Advisor

Thomas Mohr

Keywords

Meningomyelocele -- physiopathology

Abstract

Depending on the area of the spinal cord affected and the resultant degree of muscle paralysis, frequently ambulation is affected in the individual with myelodysplasia. While the ambulatory outcome of individuals with thoracic region myelomeningocele is unfavorable, those with sacral myelomeningocele hold excellent prognosis for functional ambulation. The walking potential of individuals with lumbar myelomeningocele, however, is less clear. Experts agree that, in addition to neurosegmental lesion level, several other factors can influence the ambulatory status of lumbar myelodysplastics. However, experts disagree on the relative significance of the individual factors. The purpose of this study was to analyze various factors cited by experts to be significant in affecting walking ability in individuals with lumbar myelodysplasia. Methodology entailed a retrospective chart review of 19 cases over the age of 18 years. The cases were reviewed at various age intervals representing childhood, adolescence, and adulthood. The results of this study revealed that the region of the myelomeningocele, extent of bracing, and knee contractures at all three age intervals were significantly associated with a decline in ambulatory status by the time the individual reached adulthood. The type of assistive device at age four to five years and scoliosis at 12 years were also significant predictors of course of ambulation into adulthood. The methodology and results of this study indicated a need for further longitudinal studies of interval and ratio data based on standardized clinical evaluations to increase the accuracy of walking prognosis in lumbar myelodysplasia.

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