Motor Development Toward Ambulation in Preschool Children with Myelomeningocele-A Prospective Study

Purpose: To describe motor development toward ambulation in children with myelomeningocele. Methods: Forty-three children were followed prospectively from 6 months to 6 years of age. Results: Walking function had been achieved at the 1-year follow-up in 2 of 38 children, at the 1.5-year follow-up in 7 of 39, at the 2-year follow-up in 14 of 36, at the 3-year follow-up in 21 of 28, at the 4-year follow-up in 28 of 36, and at the 6-year follow-up in 30 of 38. At the 6-year follow-up, spasticity was present in 22 of 38 children, 42 of 43 used orthoses, and 9 children had not achieved ambulation expected with respect to muscle function. Conclusions: In children with myelomeningocele, walking starts in some during the first year of life and is seen increasingly more frequently until 6 years of age. Motor development before ambulation varies among children with similar muscle function. An increased incidence of spasticity is found among those not having achieved ambulation with respect to muscle function. (Pediatr Phys Ther 2010; 22: 52-60)