title: Functional gait comparison between children with myelomeningocele: shunt versus no shunt.
abstract: The aim of this study was to compare functional gait differences between patients with myelomeningocele (MM) who have a ventriculoperitoneal shunt (VPS) with those who do not. Our analyses were adjusted for confounding by age, lesion level, orthotic use, and assistive device use. The Functional Mobility Scale (FMS) was used to compare the shunted group (n=98; 60 males, 38 females; mean age 10y 2mo [SD 3y 11mo]; 73 sacral/19 low lumber/six high lumbar lesion level) with the non-shunted group (n=63; 32 males, 31 females; mean age 9y 11mo [SD 3y 11mo]; 45 sacral/12 low lumber/six high lumbar lesion level). Participants with a shunt had lower FMS 500 and FMS 50 scores compared with participants without a shunt; hence the participants without a shunt were more independent in their ambulation at medium and longer distances. For a subset of participants who underwent a three-dimensional gait analysis, we also collected temporal-spatial gait parameters (velocity, cadence, and stride length). Our results show that participants with MM and no shunt who underwent gait analysis(11 males, 10 females; mean age 9y 6mo [SD 4y]; 15 sacral/6 low lumber/0 high lumbar lesion level) tend to walk at a significantly greater velocity and stride length as compared with those with a shunt (33 males, 18 females; mean age 10y [SD 4y]; 38 sacral/13 low lumber/zero high lumbar lesion level). These data allow the treatment team to present more specific information regarding functional ambulatory expectations to patients with MM and their families.
authors: Motion Analysis Center, Children's Memorial Hospital, Chicago, Illinois 60614, USA.
authors: Simone
authors: S
authors: Battibugli
authors: Nicholas
authors: N
authors: Gryfakis
authors: Luciano
authors: L
authors: Dias
authors: Claudia
authors: C
authors: Kelp-Lenane
authors: Stephanie
authors: S
authors: Figlioli
authors: Elizabeth
authors: E
authors: Fitzgerald
authors: Nicole
authors: N
authors: Hroma
authors: Roopa
authors: R
authors: Seshadri
authors: Christine
authors: C
authors: Sullivan
mesh_terms: D002648:Child; D005260:Female; D020233:Gait Disorders, Neurologic / Q000453:epidemiology* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008591:Meningomyelocele / Q000453:epidemiology* / Q000601:surgery*; D009989:Orthotic Devices / Q000706:statistics & numerical data; D012656:Self-Help Devices / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt