scholarly journals Increased Asymmetry of Trunk, Pelvis, and Hip Motion during Gait in Ambulatory Children with Spina Bifida

Symmetry ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1595
Author(s):  
Melissa A. Bent ◽  
Eva M. Ciccodicola ◽  
Susan A. Rethlefsen ◽  
Tishya A. L. Wren
Keyword(s):  
Spina Bifida ◽  
Muscle Weakness ◽  
Neural Tube Closure ◽  
Assistive Device ◽  
Trunk Motion ◽  
Lumbar Level ◽  
Hip Motion ◽  
Motor Strength ◽  
Lesion Level ◽  
And Function

Spina bifida (SB) is caused by incomplete neural tube closure and results in multiple impairments, including muscle weakness. The severity of muscle weakness depends on the neurologic lesion level. Though typically symmetric, there can be asymmetries in neurologic lesion level, motor strength, skeletal structures, and body composition that affect patients’ gait and function. Using body segment and joint motion obtained through 3D computerized motion analysis, we evaluated asymmetry and range of motion at the hip, pelvis, and trunk in the frontal and transverse planes during gait in 57 ambulatory children with SB and 48 typically developing controls. Asymmetry and range of hip, pelvis, and trunk motion in the frontal and transverse planes were significantly greater for patients with mid-lumbar and higher level lesions compared with those having sacral/low-lumbar level lesions and controls without disability (p ≤ 0.01). Crutch use decreased asymmetry of trunk rotation in mid-lumbar level patients from 10.5° to 2.6° (p ≤ 0.01). Patients with asymmetric involvement (sacral level on one side and L3-4 on the other) functioned similarly to sacral level patients, suggesting that they may be better categorized using their stronger side rather than their weaker side as is traditional. The information gained from this study may be useful to clinicians when assessing bracing and assistive device needs for patients with asymmetric SB involvement.

Prospective, Randomized Clinical Trial Comparing a Novel Motion-Assistive Device to Standard Physical Therapy for Initial Management of Knee Range of Motion after Primary Total Knee Arthroplasty

2021 ◽  
Author(s):  
James L. Cook ◽  
Kylee Rucinski ◽  
Cory R. Crecelius ◽  
Suzin Cunningham ◽  
Trent M. Guess
Keyword(s):  
Clinical Trial ◽  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Physical Therapy ◽  
Knee Arthroplasty ◽  
Assistive Device ◽  
Initial Management ◽  
Prospective Randomized Clinical Trial ◽  
Total Knee ◽  
And Function

AbstractThis prospective randomized clinical trial assessed a novel device for initial management of knee range of motion (ROM), pain, and function after total knee arthroplasty (TKA). Primary TKA patients with preoperative ROM of at least 5° to 115° were randomized to initial knee motion management: Mizzou BioJoint Flex—novel motion-assistive device with prescribed physical therapy or standard physical therapy—prescribed physical therapy. ROM, pain score, and knee injury and osteoarthritis score for joint replacement (KOOSjr) were obtained preoperatively and 2 weeks, 6 weeks, and 3 months postoperatively. Patient satisfaction for both cohorts and subjective assessments of the MBF device were assessed at 3 months. Readmissions, reoperations, and complications were assessed through 1 year. Nineteen patients were randomized to each cohort, with no significant preoperative differences in demographics, pain score, KOOSjr score, or ROM. Six SPT (31.6%) and 3 MBF (15.8%) patients failed to regain preoperative ROM (p = 0.044). One SPT (5.3%) and eight MBF (42%) patients exceeded 125° ROM (p = 0.019) by 3 months. Total ROM (p = 0.039), pain (p = 0.0068), and function (p = 0.0027) were significantly better for MBF at 3 months. MBF patients reported significantly higher satisfaction (mean, 9.4 ± 1.1 vs. 8.0 ± 1.8, respectively; p = 0.0084). One patient in each group underwent manipulation under anesthesia. No other readmissions, reoperations, or complications were reported. A novel durable medical equipment device can provide a safe and effective patient-controlled method for initial management of knee ROM, pain, and function after primary TKA with potential clinically meaningful advantages over physical therapy alone. In conjunction with physical therapy, management with this novel knee flexion device more effectively restored knee ROM and early patient function when compared with therapy alone and was associated with higher proportions of patients regaining minimum (115°) and desired (125°) levels of knee ROM and clinically meaningful differences in pain scores, knee function, and patient satisfaction. This is a Level 1, prospective trial study.

Tethered spinal cord among individuals with myelomeningocele: an analysis of the National Spina Bifida Patient Registry

2021 ◽  
Vol 28 (1) ◽  
pp. 21-27
Author(s):  
Mark S. Dias ◽  
Ming Wang ◽  
Elias B. Rizk ◽  
Robin Bowman ◽  
Michael D. Partington ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spina Bifida ◽  
Cox Proportional Hazards ◽  
Patient Registry ◽  
Tethered Spinal Cord ◽  
Significant Treatment ◽  
Data Set ◽  
Traditional Concept ◽  
Lesion Level ◽  
Males And Females

OBJECTIVE The aims of this study were to review the National Spina Bifida Patient Registry (NSBPR) data set to study the rates of tethered spinal cord release (TCR) among patients with myelomeningocele and variability between centers, to compare TCR rates between males and females, and to study the relationships between TCR rates and other condition-specific characteristics. METHODS The NSBPR registry was queried to identify all patients with myelomeningocele. TCR rates were calculated over time using survival analyses; rates between centers and between males and females were compared. Cox proportional hazards models were constructed to identify relationships between TCR rates and sex, functional lesion level, ambulation status, treated hydrocephalus, and prior Chiari decompression. RESULTS Of 6339 patients with information about their operations, 1366 (21.5%) underwent TCR, with significant variability between centers. The majority (75.8%) underwent a single TCR. The annual TCR rate was linear between birth and 13 years (1.8%/year) but declined sharply from 14 to 21 years (0.7%/year). There was no period of time at which the TCR rate accelerated. There were no significant differences in TCR rates between males and females. TCR rate was not related to functional lesion level but was lower among nonambulators compared with community ambulators (p = 0.005) and among those with treated hydrocephalus (HR 0.30, p < 0.001), and higher among those having prior Chiari decompression (HR 1.71, p < 0.001). CONCLUSIONS These results extend the results of prior single-institution studies, demonstrate significant treatment variability between institutions, and challenge the traditional concept that tethering is related to spinal cord stretching due to spinal growth.

Comparison between Tc-99m DMSA and Renal Ultrasonography for the Evaluation of Renal Scarring and Function Loss in Children with Spina Bifida

2017 ◽  
Vol 18 (2) ◽  
pp. 76-79
Author(s):  
Ebru Ozgonenel ◽  
Isik Karalok ◽  
Emel Ceylan Gunay ◽  
Tomris Duymaz ◽  
Ibrahim Alatas ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Renal Scarring ◽  
Renal Ultrasonography ◽  
Function Loss ◽  
And Function

Unilateral hip subluxation in the low lumbar level spina bifida child: A gait analysis evaluation

1994 ◽  
Vol 2 (1) ◽  
pp. 60
Author(s):  
Eiffel Dobashi ◽  
Luciano Dias ◽  
John Sarwark ◽  
Carolyn Moore ◽  
Stephen Vankoski
Keyword(s):  
Spina Bifida ◽  
Gait Analysis ◽  
Lumbar Level

Scope of care in the first four years of life for individuals born with myelomeningocele: A single institution experience1

2021 ◽  
pp. 1-7
Author(s):  
Betsy Hopson ◽  
Isaac Shamblin ◽  
Kathrin Zimmerman ◽  
Brandon Rocque ◽  
Arsalaan Salehani ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Surgical Procedures ◽  
Hospital Admissions ◽  
Demographic Data ◽  
Newborn Infants ◽  
Surgical Care ◽  
Primary Diagnosis ◽  
Lesion Level ◽  
The Mean ◽  
Hospital Visits

PURPOSE: Children with myelomeningocele are known to be consumers of substantial healthcare resources, with many early hospital encounters. The purpose of this study was to survey the extent of medical and surgical care that patients with myelomeningocele receive during the first four years of life. METHODS: Clinical and demographic data were collected on newborn infants with open myelomeningocele from the Children’s of Alabama Spina Bifida Web Tracker, a prospective, comprehensive spina bifida database. Additional data pertaining to all hospital admissions, surgical procedures, and clinic visits were collected from the medical record. RESULTS: One hundred and fourteen subjects with a primary diagnosis of myelomeningocele between 2004 and 2015 were included. Males slightly predominated (55%), 72%were Caucasian, 11%Hispanic/Latino; 28%had a mid-lumbar functional lesion level. Over the first four years of life, 688 total surgical procedures were performed (an average of 86 per child): 438 in year 1, 100 in year 2, 84 in year 3, and 66 in year 4. The mean number of hospital visits was 40.5. Total average drive time per patient over 4 years being 103.8 hours. Average number of nights spent in the hospital was 51. CONCLUSION: Children with myelomeningocele need multiple hospitalizations, surgeries, and medical encounters in the first 4 years of life. These data will be valuable when counselling new parents and prospective parents of children with this condition.

scholarly journals Heritability of cranium bifidum and spina bifida in the golden hamster

1979 ◽  
Vol 34 (2) ◽  
pp. 189-194 ◽  
Author(s):  
A. M. Moffa ◽  
J. A. White
Keyword(s):  
Environmental Factors ◽  
Spina Bifida ◽  
Neural Tube ◽  
Golden Hamster ◽  
Average Frequency ◽  
Neural Tube Closure ◽  
Cranium Bifidum ◽  
Tube Closure ◽  
Half Sibling ◽  
Neural Tube Closure Defects

SUMMARYThe heritability (h2) and frequency of the neural tube closure defects, cranium bifidum (CB) and spina bifida (SB), have been estimated for a population of 9-day-old hamster embryos through half-sibling analysis. The average frequency of the total affected embryos per litter is approximately 17% while the pooled estimate for h2 based on between sires and between dams within sires components was 4%. This value points to the importance of environmental factors in contributing to the variance in defect frequencies observed within this population.

scholarly journals Structure, Integrity, and Function of the Hypoplastic Corpus Callosum in Spina Bifida Myelomeningocele

2014 ◽  
Vol 4 (8) ◽  
pp. 608-618 ◽  
Author(s):  
Jennifer T. Crawley ◽  
Khader Hasan ◽  
H. Julia Hannay ◽  
Maureen Dennis ◽  
Catherine Jockell ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Corpus Callosum ◽  
And Function

Postfolate spina bifida lesion level change

2018 ◽  
Vol 110 (11) ◽  
pp. 949-955
Author(s):  
Carin Eldridge ◽  
Sruti Bandlamuri ◽  
Jennifer G. Andrews ◽  
Maureen Kelly Galindo ◽  
Dianna Contreras ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Level Change ◽  
Lesion Level

scholarly journals Myelomeningocele Surgery over the 10 Years Following the MOMS Trial: A Systematic Review of Outcomes in Prenatal versus Postnatal Surgical Repair

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 707
Author(s):  
Francesca Gabriela Paslaru ◽  
Anca Maria Panaitescu ◽  
George Iancu ◽  
Alina Veduta ◽  
Nicolae Gica ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spina Bifida ◽  
Neural Tube ◽  
Severe Form ◽  
Neural Tube Closure ◽  
Reference List ◽  
Hand Search ◽  
Randomized Controlled ◽  
Associated Conditions

Background and Objectives: Myelomeningocele is the most severe form of spina bifida, a congenital neural tube defect arising from an incomplete neural tube closure during early development with damage worsening with advancing gestational age. The Management of Myelomeningocele Study (MOMS) Trial proved that surgery performed before 26 weeks of gestation significantly improved the prognosis, significantly changing treatment paradigms. This article aims to provide a review of the changes and updates in spina bifida repair over the 10-year period following the MOMS Trial. Material and methods: We performed a systematic review in the PubMed and Cochrane databases as well as a hand-search of high-impact journals using the reference list of all identified articles, searching for randomized controlled trials and observational studies. Results: We identified 27 articles published between 2011 and 2021 that fulfilled the inclusion criteria and review them in the present study. Conclusions: With growing experience and with the improvement of prenatal open and fetoscopic techniques, the outcome of SB-associated conditions could be improved and the risks to both the mother and the fetus reduced. A continuous follow-up of the treated infants and further randomized trials are essential to study the complications and advantages or disadvantages of any given treatment strategy.

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