Motor Development Toward Ambulation in Preschool Children with Myelomeningocele—A Prospective Study

In Brief Purpose: To describe motor development toward ambulation in children with myelomeningocele. Methods: Forty-three children were followed prospectively from 6 months to 6 years of age. Results: Walking function had been achieved at the 1-year follow-up in 2 of 38 children, at the 1.5-year follow-up in 7 of 39, at the 2-year follow-up in 14 of 36, at the 3-year follow-up in 21 of 28, at the 4-year follow-up in 28 of 36, and at the 6-year follow-up in 30 of 38. At the 6-year follow-up, spasticity was present in 22 of 38 children, 42 of 43 used orthoses, and 9 children had not achieved ambulation expected with respect to muscle function. Conclusions: In children with myelomeningocele, walking starts in some during the first year of life and is seen increasingly more frequently until 6 years of age. Motor development before ambulation varies among children with similar muscle function. An increased incidence of spasticity is found among those not having achieved ambulation with respect to muscle function. The author reports that motor development prior to ambulation varies in children with myelomeningocele who exhibit similar muscle function, and that spasticity is found among those who do not achieve ambulation as would be predicted by muscle function.