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Does locomotion improve the cognitive profile of children with meningomyelocele?
C Rendeli1, E Salvaggio, G Sciascia Cannizzaro
1Spina Bifida Centre, Paediatric Department, Policlinico Gemelli, Largo Gemelli 8, 00168 Rome, Italy.
Insights
Locomotion, such as walking, may enhance cognitive development in children with meningomyelocele (MMC) and hydrocephalus. Ambulatory children with MMC showed significantly better performance IQ scores than those using wheelchairs.
Area of Science:
- Pediatric Neurology
- Developmental Neuroscience
- Rehabilitation Medicine
Background:
- Meningomyelocele (MMC) and hydrocephalus are congenital conditions often leading to motor impairments.
- Cognitive development in children with MMC can be affected by neurological complications.
- The impact of locomotion on cognitive outcomes in this population requires further investigation.
Purpose of the Study:
- To test the hypothesis that improved locomotion can positively influence cognitive development.
- To assess cognitive differences between ambulatory children with MMC and those reliant on wheelchairs.
- To explore the relationship between motor function and intellectual performance in pediatric MMC.
Main Methods:
- A cohort of 29 children with MMC and shunted hydrocephalus underwent physiotherapy and mobility training.
- Neuroimaging (CT/MRI) was used to evaluate brain structure and hydrocephalus severity.
- Neuropsychological assessments, including WIPPSI and WISC-R, measured cognitive abilities.
Main Results:
- While global IQ was within the normal range, a split between verbal and performance IQ was noted.
- Ambulatory children (with or without aids) demonstrated significantly higher performance IQ scores (83-85) compared to wheelchair-dependent children (63).
- Statistical analysis confirmed a significant difference in performance-related outcomes based on mobility status (P=0.044, P=0.012).
Conclusions:
- Locomotion, facilitated by physiotherapy, appears to be associated with enhanced cognitive performance, specifically in the performance IQ domain.
- Mobility status is a significant factor influencing cognitive outcomes in children with MMC and hydrocephalus.
- Interventions promoting ambulation may be beneficial for improving cognitive development in this vulnerable pediatric population.
Objective:
This study was conducted to test the hypothesis that locomotion can improve cognitive development in a paediatric population with meningomyelocele (MMC) and hydrocephalus.
Methods:
Twenty-nine children with MMC and shunted hydrocephalus were studied. All had motor impairment, but after physiotherapy and training walking was possible in 23 of them (5 autonomously and 18 with an aid), while 6 had recourse to a wheelchair. In all 23 cases neuroimaging (TC scan and/or MRI) was performed to obtain data on the sequelae of perinatal lesions, alterations of the corpus callosum, and the presence or absence of cortical abnormalities and ventricular dilatation. All subjects underwent a neuropsychological assessment including the Wechsler Pre-school and Primary Scale for Infants (WIPPSI) and the Wechsler Intelligence Scale for Children Revisited (WISC-R). Statistical analysis was carried out with the ANOVA test.
Results:
Even though global I.Q. in these MMC children was within the normal range, the characteristic splitting between verbal I.Q. (VIQ) and performance I.Q. (PIQ) was observed, but the most interesting observation was a significant performance-related difference (P=0.044 and P=0.012) between ambulatory patients (both with and without aids) and those who were dependent on wheelchairs (PIQ: 83-85 vs 63).