Lullo et al reviewed factors associated with walking activity in a pediatric patient with myelomeningocele. This can help to identify a patient who may benefit from more aggressive management. The authors are from Harbor-UCLA Medical Center, Children's Hospital Los Angeles, University of Southern California and University of Nevada Las Vegas.
Patient selection: pediatric patient with myelomeningocele
Outcome: walking activity as steps per day
Factors associated with reduced walking activity:
(1) functional level (mid-lumbar or higher)
(2) placement of a shunt (for hydrocephalus)
(3) use of an assistive device (crutches < walker < both)
(4) hours watching TV and other sedentary activities
(5) obesity
(6) lower extremity contractures
(7) lower muscle strength in the lower extremities
(8) increasing age
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