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Physical therapy interventions for children and adolescents with myelomeningocele: A systematic review
Lorena Costa Ferreira1, Isabella Saraiva Christovão1, Robert J Palisano2
1Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Aim:
To systematically review the current evidence on physical therapy interventions for children and adolescents with myelomeningocele, the most complex and common presentation of spina bifida, to explore intervention components and the outcomes according to International Classification of Functioning, Disability and Health (ICF) domains, and to evaluate the level of evidence and methodological quality of the studies.
Methods:
The MEDLINE/PubMed, Embase, Cochrane, Scopus, Web of Science, PEDro, and BVS databases were searched from inception to May 2026. Methodological quality was appraised using JBI critical appraisal tools, and levels of evidence were based on recommendations of the Oxford Centre for Evidence-Based Medicine.
Results:
A total of 36 studies were included, involving 532 children and adolescents aged from 1 month to 18 years. The most frequently investigated interventions were electrical stimulation (n = 9), treadmill training (n = 4), and whole-body vibration (n = 3). Eighteen studies were rated as high methodological quality, ten as moderate quality, and eight as low quality.
Interpretation:
A wide range of physical therapy interventions have been investigated for children and adolescents with myelomeningocele across multiple ICF domains. Although interventions such as electrical stimulation, treadmill training, serial casting, and laser therapy showed favorable outcomes in specific domains, the available evidence remains limited and heterogeneous, precluding definitive conclusions about their effectiveness.
