Factors Associated With Ambulation and Transfer Ability: A Study From the National Spina Bifida Patient Registry.
Nicholas L Benjamin, Gina McKernan, Sara Izzo and 5 others
PMID 34508059WHAT IT FOUND
Motor level remains the strongest predictor of walking and transfer ability in spina bifida.
Distal surgeries like foot corrections associate with better function, while proximal surgeries like spine or hip repairs associate with worse function, likely reflecting underlying severity rather than treatment effects.
Key findings
01Motor level is the predominant factor associated with baseline transfer ability and ambulation.
02Surgeries distal to the knee are associated with higher functional levels, while surgeries proximal to the knee are associated with lower functional levels.
03The number of shunt revisions was not a significant predictor of ambulation or transfer ability.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study is observational, so causation cannot be assumed; surgeries may reflect underlying severity rather than causing functional changes. The non-MMC group had a small sample size and limited variability in function, reducing the ability to detect significant predictors. The registry does not capture complete histories of all orthopedic or neurosurgical conditions unless surgery was performed. Timing of surgeries was not accounted for in the models. Obesity was not included as a variable due to measurement difficulties.
Declared interests
Funded by the Centers for Disease Control and Prevention. The authors declared no competing interests.
The easy way to misread this
Do not interpret the association between proximal surgeries and worse function as evidence that these surgeries cause decline. They likely serve as markers for more severe underlying conditions or higher motor levels.