Predictors of Walking Activity in Children and Adolescents With Myelomeningocele.
Brett Lullo, Nicole Mueske, Carmel Diamant and 3 others
PMID 31778661WHAT IT FOUND
Less daily walking was related to using assistive devices and watching more TV in ambulatory children and adolescents with myelomeningocele.
Strength and range of motion were also related, but not in the final model.
Key findings
01In the final model, only assistive device use and hours of television watched per week remained significant predictors of steps per day.
02The final model had an R 2 value of 0.60, compared with 0.53 for a model with only assistive device use and 0.07 for a model with only hours of TV watching.
03In a secondary analysis, assistive device use was related to higher lesion level, history of shunt placement, decreased hip extension and abduction strength, knee flexion strength, ankle dorsiflexion and plantarflexion strength, and knee and hip extension range of motion.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The analysis included 52 children, a subset of 83 from the parent study, so it may have had limited power to detect relationships. The sample was 90% Hispanic, so the results may not generalize well to non-Hispanic populations. Manual muscle testing was used for strength, which the authors say is subjective and may miss small strength differences. The StepWatch measured steps for one week, but the study could not confirm whether braces or assistive devices were used for all walking during that week. Television hours were self-reported by participants and parents together, so reporter bias is possible. Hip extension range of motion was recorded as 0 degrees when no contracture was present, and the Thomas test method did not allow posterior pelvic tilt, which may under-detect hip extension contracture.
Declared interests
The supplied metadata lists NIH extramural research support. The article text does not include a separate conflicts-of-interest declaration.
The easy way to misread this
Do not conclude that assistive devices cause less walking or that reducing television will increase steps. The study only identified variables related to step counts, and assistive device use was also linked to higher lesion level, shunt history, and lower strength or range of motion.