Spina Bifida physical therapy treatment
Kayla Gallegos, DPT
In this article, you will learn about spina bifida physical therapy treatment from a pediatric physical therapist. She will discuss what Spina Bifida is and how physical therapy can help.
What is Spina Bifida?
Spina Bifida is a neural tube defect that occurs during a child’s development in utero. In typical neural development, the outermost layer of cells (ectoderm) folds in on itself to form the neural tube that extends from the brain to the end of the spine. When this does not occur, an opening in the neural tube remains. Since the neural tube is open, the vertebrae of the spine cannot fully close either.
Spina Bifida can be classified as either Occulta or Cystica (Aperta). In Spina Bifida Occulta, the vertebra is open but the defect is not physically visible from the outside. The skin may have small benign fatty tumor, discoloration, and/or hair overlying the defect. In Spina Bifida Cystica or Aperta, the vertebra is open and the meninges may protrude out of the spinal canal appearing like a bubbling of skin on the child’s back.
There are four types of Spina Bifida including occulta, closed neural tube defects, meningocele, or myelomeningocele. In occulta, only the vertebrae are malformed. In closed neural tube defects, there may be malformation of the bone, fat, and meninges. With meningoceles, there is spinal fluid and meninges protruding but the spinal cord stays within the spinal canal. Myelomeningocele is the most severe type where the spinal cord and other neural elements protrude from the spinal canal.
What can physical therapy help with?
Spina Bifida can cause a number of impairments including muscle weakness, joint contractures, decreased bone density, loss of sensation, and disruption of the neuromuscular system. The presentation of a child with Spina Bifida depends on their age and the level of the defect. The level is defined as the lowest intact, functional neuromuscular segment. For example, if it is at the spinal level L4, they will be able to use their hip flexors, hip adductors, and knee extensors, but may have paralysis and loss of sensation in the other muscles of the lower extremities. During the initial physical therapy evaluation, the PT will examine the child’s range of motion, strength, tone, endurance, sensation, and other neuromuscular components. Based on the results from the initial evaluation, the PT can provide interventions appropriate for the patient. Some things physical therapy can help with include strengthening, stretching, functional mobility, gait training, providing or referring for orthotics or assistive devices, and providing education to the patient and family about activities to work on at home.
At Ability Innovations, we use a play-based therapy approach to work toward the child’s goals in a stimulating and fun way. If you are interested in physical therapy for your child for any reason, please call to schedule a free consultation!
References:
1. Palisano RJ, Orlin MN, Schreiber J. Campbell’s Physical Therapy for Children. 5th ed. St. Louis, MO: Elsevier, Inc; 2017.
2. Spina Bifida Association. Available at: http://spinabifidaassociation.org/. Accessed May 3, 2023.
3. Spina bifida. DINOSAUR PHYSICAL THERAPY. (2020, July 6). Accessed May 3, 2023, from
https://blog.dinopt.com/spina-bifida/
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