Upper body movement during walking in children with lumbo-sacral myelomeningocele

Area of Science:

• Biomechanical analysis
• Pediatric orthopedics
• Neuromuscular disorders

Background:

• Myelomeningocele (MMC) often results in lower extremity weakness, affecting ambulation.
• Understanding compensatory upper body movements is crucial for gait analysis in children with MMC.
• Orthotic use is common but its effect on upper body kinematics needs further investigation.

Purpose of the Study:

• To investigate the relationship between lower extremity muscle strength and upper body movement during walking in children with MMC.
• To compare upper body kinematics between different strength groups of children with MMC and healthy controls.
• To assess the influence of orthotic type on observed movement patterns.

Main Methods:

• Three-dimensional movement analysis of eight children with lumbo-sacral MMC and fourteen controls.
• Classification of MMC children into strength groups based on hip extensor and abductor muscle function.
• Measurement of shoulder, trunk, and pelvis segment displacements during independent walking with orthoses.

Main Results:

• Children with MMC exhibited significantly greater upper body segment displacements than controls.
• MMC children with poorer hip muscle strength (Group II) showed approximately double the frontal and transverse plane displacements compared to those with better strength (Group I).
• No significant differences in segment motion were observed between Ferrari-type knee-ankle-foot orthoses and ankle-foot orthoses.

Conclusions:

• The degree of lower extremity muscle weakness in children with MMC directly correlates with increased upper body motion amplitudes during walking.
• Compensatory upper body movements are pronounced in children with more severe hip muscle weakness.
• Orthotic type did not significantly alter the observed upper body kinematic patterns in this cohort.