Walking and living independently with spina bifida: a 50-year prospective cohort study.
Pippa Oakeshott, Alison Poulton, Gillian M Hunt and 1 others
PMID 30674090WHAT IT FOUND
Walking ability declined from 51% in childhood to 27% at age 50.
However, independent living increased from 23% to 54% over the same period, partly because those with severe deficits died younger. Neurological level at birth and shunt history predicted long-term outcomes.
Key findings
01The percentage of survivors who could walk more than 50m dropped from 51% at age 9 to 27% at age 50.
02The percentage of survivors living independently increased from 23% at age 25 to 54% at age 50.
03Survival to age 50 was significantly better for those born with a sensory level below L3 (54%) compared to those with higher levels (22%).
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 cohort was born between 1963 and 1971, so medical management has improved since then, and findings may not reflect current prognosis. Later reviews relied on questionnaires and telephone interviews rather than objective clinical assessments. The sample size of survivors at age 50 was small (n=37). Findings may not generalize to different healthcare systems or non-white ethnicities. The study is largely descriptive and could not adjust for all potential confounders due to small sample size.
Declared interests
None stated in the provided text.
The easy way to misread this
Do not interpret the increase in independent living from 23% to 54% as a sign that treatment has improved independence. This rise is largely because individuals with severe neurological deficits died younger, leaving a survivor group with milder impairments.