[A follow up study of spastic diplegia in Shiga Prefecture--ambulatory function and career course after school age]

This study investigated the changes in ambulatory function in individuals with spastic diplegia from 6 (the age at which children start going to elementary school in Japan) to 18 years of age (the age at which children leave high school) in Shiga Prefecture. Sixty-two patients with spastic diplegia (19-28 years of age, born between 1977 and 1986) were studied. Ambulatory function at 18 years of age was compared with that at 6 years of age. Ambulatory ability tended to improve up to 9 years of age, and was maintained at its optimal level between the age of 9 and 11. In some patients, ambulatory function decreased thereafter. Of 62 patients, 43 (69%) attained unaided ambulation, and 48 (77%) could walk with or without the use of crutches by the age of 18. Those who could walk unaided at the age of 6 years (39 of 62; 63%) maintained independent ambulation at the age of 18 years, although some complained of pain and/or fatigue. Employment at 18 years of age was limited to individuals who could walk with or without crutches. Of two wheelchair-bound patients, one went on to study at the university level and the other went on to a special school. When children with spastic diplegia reached age 18, their career course correlated with the degree of mental retardation. Individuals without mental retardation were employed or went on to higher education.