Pediatrics: Spina Bifida: Orthotics and Functional Prognosis

Question 1

Lesion: Thoracic: Muscle Activity

Answer 1

• No hip flexion

Question 2

Lesion: Thoracic: Orthosis

Answer 2

• Trunk, hip, knee, ankle, foot orthosis
• Reciprocating gait orthosis
• Parapodium/stander

Question 3

Lesion: Thoracic: Assistive Device

Answer 3

• Walker

Question 4

Lesion: Thoracic: Wheelchair

Answer 4

• Typically manual

- Power for longer distances

Question 5

Lesion: Thoracic: Functional Prognosis

Answer 5

• Wheelchair for all mobility

- Standing and walking for physiologic benefits only

Question 6

Lesion: L1-L2: Muscle Activity

Answer 6

• Some Hip flexion
• L1: Psoas major (Less than 3/5)
• L2: Psoas major, iliacus, sartorious, pectineus (Greater than 3/5)

Question 7

Lesion: L1-L2: Orthosis

Answer 7

• Knee, ankle, foot orthosis

Question 8

Lesion: L1-L2: Assistive Device

Answer 8

• Walker

- Forearm crutches

Question 9

Lesion: L1-L2: Wheelchair

Answer 9

• Manual

Question 10

Lesion: L1-L2: Functional Prognosis

Answer 10

• Wheelchair for most mobility

- Ambulation for short household distances

Question 11

Lesion: L3: Muscle Activity

Answer 11

• Strong hip flexion
• Weak hip rotator
• At least antigravity knee extension
• Partial innervation of: Sartorious, gracilis, and quadriceps

Question 12

Lesion: L3: Orthosis

Answer 12

• Knee, ankle foot orthosis if quadriceps MMT less than 4/5

- Ankle foot orthosis if quadriceps MMT greater than 4/5

Question 13

Lesion L3: Assistive Device

Answer 13

• Walker

- Forearm crutches

Question 14

Lesion: L3: Wheelchair

Answer 14

• Manual wheelchair

Question 15

Lesion: L3: Functional Prognosis

Answer 15

• Wheelchair for the community

- Ambulation primary means if using AFO

Question 16

Lesion L4: Muscle Activity

Answer 16

• Partial innervation of:
• Tibialis Anterior
• Perneous tertius
• Tensor fascia latae
• Gluteus medius
• Gluetus minimus

Question 17

Lesion L4: Orthosis

Answer 17

• Ankle, foot orthosis with posterior stop

Question 18

Lesion L4: Assistive Device

Answer 18

• Forearm crutches

- Canes

Question 19

Lesion L4: Wheelchair

Answer 19

• None

Question 20

Lesion L4: Functional Prognosis

Answer 20

• Community Ambulation

Question 21

Lesion: L5: Muscle Activity

Answer 21

Partial Innervation of
- Hamstrings
- Tibialis posterior
- Peroneus longus and brevis
- Extensor hallucis longus
- Flexor digitorum longus
- Flexor hallucis longus
Full Innervation of
- Peroneus tertius
- Extensor digitorum longus

Question 22

Lesion: L5: Orthosis

Answer 22

• Ankle, foot orthosis with posterior stop

Question 23

Lesion: L5: Assistive Device

Answer 23

• Canes

Question 24

Lesion: L5: Wheelchair

Answer 24

• None

Question 25

Lesion: L5: Functional Prognosis

Answer 25

• Community ambulation

Question 26

Lesion: S1: Muscle Activity

Answer 26

• Full innervation of hamstrings

- Partial innervation of gluteus Maximus, Gastrocnemius, Soleus

Question 27

Lesion: S1: Orthosis

Answer 27

• Foot Orthosis

- Maybe ankle, foot orthosis

Question 28

Lesion S1: Assistive Device

Answer 28

• None

Question 29

Lesion: S1: Wheelchair

Answer 29

• None

Question 30

Lesion: S1: Functional Prognosis

Answer 30

• Community ambulation

Question 31

Lesion S2: Muscle Activation

Answer 31

• Good strength for gait

Question 32

Lesion S2: Orthosis

Answer 32

• No orthosis

Question 33

Lesion S2: Assistive Device

Answer 33

• None

Question 34

Lesion S2: Wheelchair

Answer 34

• None

Question 35

Lesion S2: Functional Prognosis

Answer 35

• Community Ambulation