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Factors Associated With Ambulation and Transfer Ability: A Study From the National Spina Bifida Patient Registry
Nicholas L Benjamin1, Gina McKernan, Sara Izzo
1From the Drexel University College of Medicine, Philadelphia, Pennsylvania (NLB); Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (GM, SI, AJH, BED); Veterans Affairs Pittsburgh Healthcare System, Human Engineering Research Laboratories, Pittsburgh, Pennsylvania (GM, TMC, BED); Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania (TMC, BED); and Department of Physical Medicine and Rehabilitation, The Children's Hospital of Colorado, Aurora, Colorado (GHC, PEW).
Objectives:
This study used a spina bifida electronic medical record and the National Spina Bifida Patient Registry to explore the relationship between neurosurgical/orthopedic surgeries and other variables on ambulation and transfer ability over time in individuals with spina bifida.
Design:
This study was an analysis of longitudinal data collected within the National Spina Bifida Patient Registry and spina bifida electronic medical record. Logistic regression models were used to determine which variables were associated with ambulation/transfer ability in the myelomeningocele (MMC) and non-MMC populations.
Results:
Longitudinal data from 806 individuals were collected. In the MMC group, decreased ambulation ability was associated with higher motor levels, tethered cord releases, spine/scoliosis surgeries, hip orthopedic surgeries, and having supplemental insurance. Increased ambulatory ability was associated with lower motor levels, tibial torsion/related surgeries, ankle/foot surgeries, being female, and being non-Hispanic/Latinx. Decreased transfer ability was associated with being Hispanic/Latinx and having higher motor levels. Lower motor level and ankle/foot surgeries were associated with increased transfer ability. No significant associations were found in the non-MMC group.
Conclusions:
Motor level is an important predictor of ambulation and transfer ability in MMC. Surgeries distal to the knee were associated with higher levels of function; surgeries proximal to the knee were associated with lower functional levels.
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