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Journal of the Korean Academy of Rehabilitation Medicine 1998;22(4):840-847.
Ambulation of Spina Bifida Patients.
Bang, Moon Suk , Han, Tai Ryoon , Kim, Jin Ho , Lee, Kyeong Woo , Lee, In Sik
Department of Rehabilitation Medicine, Seoul National University College of Medicine.
이분 척추 환자들의 보행
방문석, 한태륜, 김진호, 이경우, 이인식
서울대학교 의과대학 재활의학교실
Abstract

Objective
To investigate the ambulatory status and its contributing factors in eighty one patients with spina bifida, and to obtain informations about the actual state and the problems of their orthotic uses for the lower limbs.


Method
Eighty one spina bifida patients above thirty months of age who registered to the Myelomeningocele Clinic of Seoul National University Hospital were investigated through the telephone interviews and the retrospective reviews of the medical records by a physiatrist.


Results
About one half of 81 spina bifida patients had problems in their ambulation. It was significantly influenced by the neurological level, the type of spina bifida, the contractures and deformities of the lower limbs, and presence of hydrocephalus. The deformity of hip and the neurological level were revealed to be the most important factors contributing to their state of ambulation by the multiple linear logistic analysis(p<0.01). Forty patients had used the lower limb orthoses of which the ankle-foot-orthosis was most frequently used. The satisfaction and compliance of the patients, however, were not high and the most common complaint of the parents was a skin wound from the use of orthoses.


Conclusion
The neurological level and the deformity of hip were the two most important contributing factors to the ambulation of the spina bifida patients. Early detection of the neurological level and an adequate prescription of the lower limb orthoses should be stressed for the management of ambulation in spina bifida patients.

Key Words: Spina bifida, Ambulation, Neurological level, Electrophysiologic study, Orthotic use


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