SPINA disabilities among children. iii. Spina bifida occulta ·

SPINA BIFIDA

·        
A neural tube defect

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·        
Occurs during development prior to birth.

·        
Due to the incomplete development of the spinal cord ,
brain or meninges.

·        
Can happen anywhere along side of Spine.

·        
Commonly visible on back of newborn baby at birth.

·        
It may also visible as an out growth, fluid filled sack on
the spine out side the body.

That
may or may not comprise the Spinal Cord inside.

 

TYPES OF
SPINA BIFIDA

There are three
types of spina bifida:

        
i.           
Myelomeningocele

       
ii.           
Meningocele

      iii.           
Spina bifida occulta

 

        
i.           
Myelomeningocele : 

·        
most common

·        
severe type of spina bifida

·        
also termed as open spina bifia

·        
This condition includes a sack that contains the parts of
spinal cord and nerves, outside the opening, somewhere on the spine at the back
of baby.

·        
This causes the damage of spinal cord and neves in the sack
to get damage.

 

Children
with myelomeningocele:

·        
They have physical disabilities

·        
The intensity of disabilities may range from moderate to
sever.

·        
disabilities may include:

o  
Movement inability

o  
Inability to feel their legs or feet

o  
incontinence

o  
Feel difficulty in going to the bathroom

 

       
ii.           
Meningocele

·        
also contains Fluid filled sack in the back of baby outside
an opening.

·        
IN this condition there is not any part of the spinal cord
present in the sack.

·        
Due to this factor there are not much nerve damages.

·        
This causes just minor disabilities among children.

 

      iii.           
Spina bifida occulta

·        
A mild kind of spina bifida.

·        
Sometime  termed as
Hidden spina Bifida

·        
May not produce any disability and go unnoticed till later
in life.

·        
There is only a gap in spine and commonly no oprning in the
back of baby.

·        
No damage to the spine or spinal cord in this type

 

CHILDREN
WITH SPINA BIFIDA

·        
Treatment focus in children with Spina Bifida is to
determine the extent of the symptoms and the development of disabilities.

·        
This also focuses on how to prevent those disabilities
which can be prevented.

·        
This requires the suitable and exact rehabilitation program
and medical treatment which carry along the development of the child.

·        
Positive attitude is mandatory for parents and clinical
professionals to mange the situation for longer time. This will develop the
positive outlook of the child.

 

FACTORS
AFFECTING THE EVENTUAL AMBULATORY STATUS OF CHILDREN WITH SPINA BIFIDA

Factors which may
affect the children with spina bifida and their treatment outcomes are:

(1)
visual and motor perception impairment

(2)
musculoskeletal deformity degree

(3)
sensory impairment

(4)
acquired obesity

(5)
existing muscle strength

(6)
neurological involvement level

 (7) patient motivation

 (8) family support

·        
Level of the motor function and the functional mobility are
the basic measures to achieve the certain degree of functional and ambulation
capability.

·        
It is needed to consider that the factors like

o  
Contractures

o  
Limited sitting balance

o  
Obesity

may
strongly effect the walking ability of child either with or without orthosis.

·        
These factors along with the mother function level of child
can toughly influence the effectiveness of the orthotic management

·        
As this is a complex major birth defect so the orthotic
management is challenging for orthosist.

·        
A complete understanding of the Spina bifida can only
develop the achievable and considerable goals.

·        
This must be very clear to the family to understand the
treatment process as well as role of the orthosis.

·        
Following are the specific factors

                                
i.           
hip disorders (e.g., dislocation, subluxation,
contractures),

                               
ii.           
knee flexion/extension contractures,

                             
iii.           
foot/ankle deformities (e.g., equinovarus, clubfoot).

In
such situations, the orthotic goal should be to prevent the deformity by
maintain the appropriate alignment of joint to achieve reasonable muscle
balance in development stage. This may result into proper weight bearing and
movement.