Interdisciplinary treatment of spina bifida children

Abstract

spina bifida children have been treated. The results of the rehabilitation programme (including orthopaedic, urological and psycho social aspects) at the time of the survey were: (a) Neuromotor function: 72% of the patients achieved ambulation, 52% of these being less than 2 years of age, and 20% older than 2 years; 18% were too young for walking. Thus, considering the children's age, about 90% of the subjects achieved the standing position, and 89% achieved ambulation. (b) Bladder function: 83% of the children had a complete urological evaluation;40% of those with a neuropathic bladder had a hyperreflexic type, 54% areflexic, and 6% normoreflexic. Thirty-two percent of the patients had signs of 'high pressure' bladder function. Urinary continence was: 36% ? 2 hours, 20% < 2 hours, 44% not detectable (age < 2 years). Forty percent of the subjects used intermittent catheterisation. (c) Psychosocial aspect: child adaptation to the disease and to the rehabilitation programme was good in 61 % of the patients; family problems were identified in 70% of the patients; enrolment in preschool and school programmes was normal (or with specialist teaching) in about 74%; 33.3% of the subjects had disturbance of affect. The results clearly showed that the interdisciplinary approach favoured the social integration of these children.

Secondary conditions in children with disabilities: spina bifida as a case example

“…Comprehensive models for interdisciplinary assessment and intervention efforts [Watson, 1991;Redaelli et al, 1992] and public health prevention initiatives require data on the nature and prevalence of secondary conditions. A review of secondary conditions in children and youth with spina bifida would contribute to such data and the identification of environmental risk factors in order to differentiate prevention and intervention initiatives.…”

Systemic effects of intravesical atropine sulphate

“…Bladder overactivity is categorized into either detrusor hyper‐reflexia (DH) or detrusor instability (DI), according to whether or not an underlying neuropathic cause has been identified [3]. DH is a common urodynamic finding in patients with spinal cord injury (SCI), multiple sclerosis (MS) and other central neuropathic conditions [4–8]; DH can cause symptoms and morbidity with potential mortality risks [9]. Typically, urinary frequency, urgency, incontinence and reflux nephropathy can occur; these symptoms often adversely affect the quality of life of the affected person [10].…”