Factors of significance for mobility in children with myelomeningocele.
OBJECTIVE
To investigate neurological impairment, hand function and cognitive function in a group of children with myelomeningocele, in order to identify factors of significance for independent mobility and the physical assistance required for mobility in daily activities.


METHODS
The study material comprised 32 children, aged 6-11 y and without mental retardation. Mobility was assessed with the Pediatric Evaluation of Disability Inventory, scored as caregiver assistance. Statistical differences and correlations between the caregiver assistance scores and the selected variables were analysed.


RESULTS
Nine children scored independent mobility. The independent children had better hand coordination (p = 0.004) and walking ability (p = 0.01), lower cele levels (p = 0.011), higher performance IQ (p = 0.027), better visuospatial function (p = 0.029) and executive function (p = 0.037) than the others. The caregiver assistance scores were lower for both the children with early and severe symptoms of brainstem dysfunction and the children with scoliosis. Statistically significant correlations were found between the need for caregiver assistance and reduced walking ability, high cele level, poor hand strength and coordination, visuospatial function, executive function and performance IQ. In the subgroup of children who needed a wheelchair or walking aids, hand strength was the only variable significantly correlated with caregiver assistance (r(s) = 0.703, p = 0.000).


CONCLUSIONS
Most of the children were dependent on others in daily activities. Impaired hand function and cognitive function were significant for mobility, and this has implications for the therapy programme in children with myelomeningocele.
Norrlin
S
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Folke Bernadottehemmet, Children's Hospital, Department of Women's and Children's Health, Section of Paediatrics, Uppsala University, Uppsala, Sweden. simone.norrlin@ped.uas.lul.se
Strinnholm
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Carlsson
M
M
Dahl
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M
D000203:Activities of Daily Living; D017028:Caregivers; D002648:Child; D003072:Cognition Disorders / Q000209:etiology* / Q000503:physiopathology* / Q000534:rehabilitation; D005260:Female; D006225:Hand / Q000503:physiopathology*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008124:Locomotion / Q000502:physiology*; D008297:Male; D008591:Meningomyelocele / Q000150:complications* / Q000503:physiopathology* / Q000534:rehabilitation; D009422:Nervous System Diseases / Q000209:etiology* / Q000503:physiopathology* / Q000534:rehabilitation; D012656:Self-Help Devices; D012720:Severity of Illness Index