Physical Therapy for Spina Bifida

Spina Bifida and Physical Therapy – Treatment Options

Birth defects such as the neural tube disorders that constitute spina bifida require ongoing care throughout the patient’s lifetime in many cases. Although surgery is a type of treatment that is commonly prescribed for those suffering from spina bifida, a child may still be left disabled if nerve damage has occurred in the womb. Physical therapy can be a valid treatment solution to improve mobility and ease discomfort.

About Spina Bifida

For unknown reasons, in the first month of an otherwise normal pregnancy the spine may fail to close properly. This can leave the spinal cord, nerves, and membranes exposed to the outside world in the most severe cases, known as myelomeningocele. The mildest form, spina bifida occulta, may only result in a birthmark over the area where the spinal cord opening lies. There is a wide range of different symptoms or signs of spina bifida, including the following:

  • Partial or total paralysis of the lower limbs
  • Bladder control problems
  • Bowel dysfunction
  • Early onset of puberty
  • Difficulty swallowing and hoarseness
  • Infections such as meningitis or encephalitis

Surgery is generally performed within the first 24 hours after a baby is born with the most severe form of spina bifida, to help prevent infection or further nerve damage. Yet even after this surgery, there could be paralysis or numbness in the limbs, which will need to be treated with physical therapy over time.

What a Physical Therapist Does

Physical therapists can help individuals who have been diagnosed with spina bifida through a series of different types of treatments. They can help teach exercises which stimulate muscle growth and tone, and improve the range of movement available. After examining the patient’s medical history, a physical therapist is able to prescribe a treatment program that is tailored to that patient’s individual interests. The main goal is to help rehabilitate any injury that has already occurred, and help the child with spina bifida become as independent in their movement as possible. Treatment is usually needed well into adulthood, if not through a patient’s entire lifetime.

Types of Treatment

Physical therapy for spina bifida falls into two main categories. To begin with, the therapist will determine if the patient needs assistance from orthopedic devices in order to move. After this, a program of movement and activity can be devised to work muscles in the optimal manner.

  • Orthopedic Devices – Many children and adults who have been diagnosed with spina bifida will need the assistance of some sort of orthopedic device in order to move efficiently. Crutches and braces are commonly given to patients by physical therapists. Wheelchairs may also be necessary in some cases, although they will not always be necessary for daily use. It may be that a patient is able to walk normally without a wheelchair, but will use this when they are taking part in group sports or more athletic activities along these lines.

 

  • Exercises and Activities – There are a number of different exercises which are ideal for children and adults suffering from spina bifida. Even with some degree of paralysis, it’s possible to work out the upper body. Some of these exercises could include bowling, swimming, yoga and pilates. There are also machines used to help stimulate muscle tone in the lower limbs, which may need extra help if they are partially paralyzed. Taking care to stretch before workouts is essential for patients with spina bifida to prevent further injury.

Spina Bifida in Adulthood

There are a few factors that will change as a child with spina bifida reaches adulthood, which could lead to some small changes in their physical therapy programs.

  • Obesity – Even with a relatively normal range of movement, obesity can be a problem for many patients who have spina bifida over time. Those who spend time in a wheelchair may exercise less frequently, leading to obesity and the development of related conditions, including hypertension, diabetes, and depression.
  • Arthritis – With the ongoing use of crutches or a reliance on braces, a patient’s joints can become weakened. This can lead to a higher prevalence of arthritis, even by the teenage years. To help fight this, physical therapists can work out a system of movement that will put less stress and pressure on the joints.
  • Shunt failure – Patients who have been diagnosed with hydrocephalus will have a shunt put in place to drain the cerebrospinal fluid. Over time, the shunt may shift positions or not work as well as it used to, in which case it will need to be moved.

With ongoing checkups and meetings with a physical therapist, it’s possible to expand and improve the range of movement for any individual with spina bifida. This can help improve a patient’s prognosis and lead to a higher quality of life.

References:

1. http://www.spinabifida-online.com/

2. http://kidshealth.org/parent/system/ill/phys_therapy.html

3. http://www.webmd.com/parenting/baby/tc/spina-bifida-treatment-overview

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