Spina Bifida
Spina bifida is a birth defect that develops when an infant’s spinal cord does not completely close during the early stages of the mother’s pregnancy. Spina bifida is diagnosed in approximately 1,500 babies born in the United States each year. The birth defect may cause both physical and intellectual disabilities.
What is Spina Bifida?
Spina bifida is a birth defect involving the spine that occurs when a baby’s “neural tube,” or fetal spinal cord, does not completely close in the early stages of development during the first month of a mother’s pregnancy. When the neural t’ube does not close, the bones of the spine that protect the spinal cord do not form as they should. Spina bifida can occur anywhere along the spine, and often results in damage to the spinal cord and surrounding nerves.
Signs and Symptoms
Spina bifida may cause both physical and intellectual disabilities that range from mild to severe. The severity of disability depends on the size and location of the opening in the spine, and the extent to which the spinal cord and nerves are affected. Babies born with spina bifida often cannot move their legs due to weakness or paralysis resulting from spinal cord and nerve damage.
People with spina bifida may have problems controlling their bowel and bladder, skin problems, orthopedic concerns, learning disabilities, problems with attention, or other neurological complications.
How Can a Physical Therapist Help?
The physical therapist is an important partner in health care and fitness for anyone diagnosed with spina bifida. Physical therapists help children and adults with spina bifida gain and maintain mobility, and function at their best throughout all stages of life. The physical therapist will also work with other health care professionals, such as orthopedists and occupational therapists, to address each individual’s needs as treatment priorities shift. Your child’s physical therapist will perform an evaluation that includes:
Birth and developmental history
The physical therapist will ask questions about the child’s birth and developmental stages (the age your child held the head upright, rolled over, sat up, crawled, walked, etc).
General health questions
The physical therapist may ask some of the following questions: Has your child been sick or hospitalized? When did your child last visit a physician or health care provider? Were any health concerns shared with you during that visit?
Parental concerns
The physical therapist will ask about your chief concerns. What are you worried about? What do you hope to accomplish first in therapy?
Physical examination
The physical exam may include measuring the child’s height and weight; observing movement patterns; making a hands-on assessment of muscle strength, tone, and flexibility; and testing the child’s balance and coordination.
Motor development tests
The physical therapist will perform specific tests to determine the child’s motor development, such as sitting, crawling, pulling up to standing, and walking. The physical therapist also may screen the child’s hand use, vision, language skills, intellect, and other areas of development.
Physical therapy may be provided
Physical therapy may be provided in a variety of locations, including the hospital, home, school, or outpatient clinics.
Physical therapists in the intensive care unit address infant positioning needs and provide parent and family education.
Early-intervention physical therapists can provide physical therapy in the home or other community-based locations to help encourage the child’s development of strength, movement, and balance skills by teaching parents specific play-based exercises.
School-based physical therapists often consult with other educational team members to help students with spina bifida participate in curricular activities, and develop independence within the school setting. They may recommend special equipment for the student to use during the school day.
Physical therapists also recommend appropriate equipment, such as braces, walkers, and wheelchairs to help people with spina bifida increase their functional mobility.
Physical therapy is also important for the prevention of other possible problems, such as obesity, by identifying activities that encourage continued participation in sports or other fitness-based activities that promote lifelong health and wellness.
