Functional performance of children with myelomeningocele

Abstract

This study aimed at analysing the impact of level of lesion, locomotion, and neurological changes associated to meningomyelocele clinical framework concerning functional performance. For this prospective cross-sectional study 40 children with meningomyelocele were assessed as to level of lesion, ambulatory ability, Arnold-Chiari malformation, hydrocephalus, hydromyelia, tethered cord, and sphincter incontinence. Functional performance was evaluated by the Pediatric Evaluation of Disability Inventory (PEDI) which quantitatively assesses functional performance and independence in daily activities in the areas of self-care, mobility, and social functioning. Collected data were statistically analysed and the significance level set at p<0.05. Lesion levels and ambulatory ability had a significant (p<0.01) impact on scores of all three PEDI areas. Limitation degree was found to be directly proportional to level of lesion. Functional performance was more severely affected in self-care and mobility activities, and the best functional scores being obtained in social functioning. In patients with thoracic lesion level, symptomatic hydromyelia proved to be a significant factor for self-care (p<0.01). Lesion level and ambulatory ability thus may be said to influence, at different levels of impact, each area of functional performance. For patients with thoracic lesion level, symptomatic hydromyelia may be pointed out as a self-care limiting factor.