Orthopaedic management of high-level spina bifida. Early walking compared with early use of a wheelchair.

Mazur, John M.; Shurtleff, David B.; Menelaus, Malcolm B.; Colliver, John Adams

doi:10.2106/00004623-198971010-00010

Cited by 106 publications

(52 citation statements)

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“…Of those, there were none at evidence level I, nine at level II 1,2,3,4,5,6,7,8,9 , none at level III, 11 at level IV 10,11,12,13,14,15,16,17,18,19,20 , and none at level V. These studies appeared to imply that there is little benefit to walking with a parapodium, hip-knee-ankle-foot orthosis, or reciprocating gait orthosis. According to the studies, most children who walked with these orthotic devices eventually gave up walking as teenagers and chose a wheelchair for a more energyefficient means of locomotion.…”

Section: Resultsmentioning

confidence: 97%

Efficacy of bracing the lower limbs and ambulation training in children with myelomeningocele

Mazur¹,

Kyle

2004

Develop Med Child Neuro

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Section: Resultsmentioning

confidence: 97%

Efficacy of bracing the lower limbs and ambulation training in children with myelomeningocele

Mazur¹,

Kyle

2004

Develop Med Child Neuro

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“…The patients who walked earlier had fewer fractures. 33 Ausili et al showed that BMD in the lumbar and femoral neck regions was improved in MMC patients who participated in athletic activities in comparison with those who did not. 26 No studies are available concerning the amount of weight bearing and ambulation necessary to maintain or increase BMD 10 to guide prescription of this treatment in patients with SB.…”

Section: Prevention and Non-pharmacological And Pharmacological Treatmentioning

confidence: 99%

Osteoporosis in paediatric patients with spina bifida

Marreiros

Loff

Calado

2012

The Journal of Spinal Cord Medicine

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The prevalence and morbidity associated with osteoporosis and fractures in patients with spina bifida (SB) highlight the importance of osteoporosis prevention and treatment in early childhood; however, the issue has received little attention. The method for the selection of appropriate patients for drug treatment has not been clarified. Objective: To review the literature concerning fracture risks and low bone density in paediatric patients with SB. We looked for studies describing state-of-the-art treatments and for prevention of secondary osteoporosis. Methods: Articles were identified through a search in the electronic database (PUBMED) supplemented with reviews of the reference lists of selected papers. The main outcome measures were incidence of fractures and risk factors for fracture, an association between bone mineral density (BMD) and occurrence of fracture, risk factors of low BMD, and effects of pharmacological and non-pharmacological treatments on BMD and on the incidence of fractures. We considered as a secondary outcome the occurrence of fractures in relation to the mechanism of injury. Results: Results indicated that patients with SB are at increased risk for fractures and low BMD. Risk factors that may predispose patients to fractures include higher levels of neurological involvement, non-ambulatory status, physical inactivity, hypercalciuria, higher body fat levels, contractures, and a previous spontaneous fracture. Limitations were observed in the number and quality of studies concerning osteoporosis prevention and treatment in paediatric patients with SB. The safety and efficiency of drugs to treat osteoporosis in adults have not been evaluated satisfactorily in children with SB.

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“…An important issue for children with a mobility limitation is that of walking versus use of another compensatory means for mobility. The question of whether, when, for how long to ambulate, and for whom ambulation is an appropriate goal is an issue evoking many varying views (e.g., Shurtleff 1986;Mazur et al 1989). Conventionally in childhood, ambulation, whatever the time cost and strain involved, has been the ultimate goal.…”

Section: Treatment Philosophies and Approachesmentioning

confidence: 99%

Children and Adolescents with Mobility Limitations

Alriksson-Schmidt

Thibadeau

2012

Handbook of Children With Special Health Care Needs

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A group of children with special health care needs, those with mobility limitations, is the focus of this chapter. We discuss the impact of mobility limitation in childhood and adolescence among those who were either born with a mobility limiting condition or those who acquired a mobility limitation at a very young age. The purpose of this chapter is to provide an overview of common important concerns and issues in the lives of children growing up with a mobility limitation. Included are related medical issues; potential treatment approaches; developmental transitioning; quality of life, pain, and depression; and finally abuse and the importance of advocacy as it relates to mobility limitation and participation in childhood and adolescence. Throughout the chapter, the normalization of the developmental experience of the child with a mobility limitation is considered and explored.

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Orthopaedic management of high-level spina bifida. Early walking compared with early use of a wheelchair.

Cited by 106 publications

References 0 publications

Efficacy of bracing the lower limbs and ambulation training in children with myelomeningocele

Efficacy of bracing the lower limbs and ambulation training in children with myelomeningocele

Osteoporosis in paediatric patients with spina bifida

Children and Adolescents with Mobility Limitations

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