title: Physical activity, exercise, and health-related measures of fitness in adults with spina bifida: a review of the literature.
abstract: Spina bifida (SB) is the most common birth defect in United States that results in permanent lifelong disability according to the Spina Bifida Association. Advancements in medical care have led to a longer life span and an increase in the risk of secondary conditions, for example, obesity, with age. The need to maintain a healthy and active lifestyle is even stronger in adults with SB than the general population. Our objective was to fill a gap in the literature by highlighting the current state of the literature on health-related measures of fitness, exercise, and physical activity (PA) in adults with SB. PubMed and Ovid were searched for articles by using the terms "spina bifida or myelomeningocele and exercise," published between January 1, 1988 and May 10, 2012. Results of studies showed that adults with SB had an inactive lifestyle, lower aerobic capacity, decreased level of daily PA, higher prevalence of obesity, and lower health-related quality of life compared with reference groups. Therapeutic interventions reduced pain, increased biomechanical efficiency during wheelchair propulsion, and improved PA and balance. Overall, the quality of the evidence on PA, exercise, and health-related measures of fitness is low in SB. Given misdistribution of adipose tissue, short stature, scoliosis, and joint contractures, future research should be conducted to determine the most reliable and low-cost methods of measuring body composition and to establish norms. Other reference standards, for example, aerobic capacity, require further development. Studies are needed to investigate lifestyle interventions that facilitate PA and exercise, and to determine the amount of exercise required to reduce secondary conditions as people with SB age.
authors: Human Engineering Research Laboratories, Veterans Administration Pittsburgh Healthcare System, Pittsburgh, PA; Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA; Center for Assistive Technology, University of Pittsburgh Medical Center, Pittsburgh, PA(∗).
authors: Theresa M
authors: TM
authors: Crytzer
authors: Human Engineering Research Laboratories, Veterans Administration Pittsburgh Healthcare System, Pittsburgh, PA; Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA; Center for Assistive Technology, University of Pittsburgh Medical Center, Pittsburgh, PA(∗); Adult Outpatient Spina Bifida Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA; Spina Bifida Clinic, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA; Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Kaufmann Medical Building, Suite 202, 3471 5th Avenue, Pittsburgh, PA 15213(†). Electronic address: dicianno@pitt.edu.
authors: Brad E
authors: BE
authors: Dicianno
authors: Indian Spinal Injuries Centre, New Delhi, India(‡).
authors: Roohi
authors: R
authors: Kapoor
mesh_terms: D000328:Adult; D001823:Body Composition; D015444:Exercise; D017079:Exercise Tolerance; D006304:Health Status; D006801:Humans; D008019:Life Style; D053580:Muscle Strength; D010809:Physical Fitness; D016135:Spinal Dysraphism / Q000503:physiopathology* / Q000534:rehabilitation*