[Current status of orthotic management of children with meningomyelocele]

The supplying of Spina bifida children with orthotic devices leads to a remarkable success only, if it is based on the preexisting possibilities of the overall development and the present situation of the child. To realize the aim of maximum autonomy in standing and walking this overall analytic perspective is a must for all therapeutic planing and decisions. Therefore, static and dynamic orthoses like hip guidance-combined with above-knee orthoses, standing and walking-aids like reciprocating gait orthoses etc. are decisive assumptions. The most important characteristics of all orthoses are, the child to feel the economizing effect concerning standing and walking. Then only optimum acceptance and integration of the orthotic devices into activities of daily living can be achieved.