Degree of paralysis in meningomyelocele and functional ...



Degree of paralysis in meningomyelocele and functional implications

Source: Charney EB. (1997). Myelomeningocele. In MW Schwartz et al (Eds). Pediatric primary care: A problem-oriented approach. 3rd ed. p812. Mosby.

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Adapted for Liptak GS. (2007). Neural Tube Defects. In Batshaw ML et al (Eds). Children with disabilities – 6th ed. p426 (Table 28.2). Brookes.

| |Mobility Status |

|Degree of |Hydrocephalus |Effect on movement |Childhood |Adulthood |

|paralysis |(%) | | | |

|Thoracic |90 |Paralysis affects the legs &|Will require extensive |Typically use wheelchairs; |

|(T1-T12) or high | |hips; causes variable |orthosis like parapodium, |community ambulation rare |

|lumbar (L1,L2) | |weakness & sensory loss in |reciprocal gait orthosis, | |

| | |the abdomen & lower body |or HKAFO | |

| | |region | | |

|Lumbar |80 |Hips flex & knees extend; |Will ambulate with less |Most use wheelchairs; |

|(L3, L4) | |ankles & toes are paralyzed |extensive orthotics, using|community ambulation is |

| | | |crutches |uncommon |

|Low lumbar (L5) |65 |Hips flex; knees extend & |Will ambulate with minimal|Most continue to be community |

| | |ankles flex; weak or absent |or no bracing, with or |ambulators |

| | |ankle extension, toe |without crutches | |

| | |flexion, and hip extension | | |

|Sacral |40 |Mild weakness of ankles |Will ambulate with minimal|Most continue to be community |

|(S1-S4) | |and/or toes |or no bracing, without |ambulators |

| | | |crutches | |

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