1) Spina bifida is a neural tube defect resulting from incomplete closure of the spinal cord during embryonic development. It can cause motor and sensory impairments depending on the level of the lesion.
2) Physiotherapy management of spina bifida aims to prevent complications, improve mobility and functional independence through exercises, orthotics, and family-centered rehabilitation from infancy.
3) Outcome measures show that physiotherapy effectively improves mobility and independence in children with spina bifida.
Spina Bifida: Physiotherapy in the management of meningomyeloceleAyobami Ayodele
Spina bifida is a treatable spinal cord malformation that occurs in varying degrees of severity. Meningomyelocele is associated with abnormal development of the cranial neural tube, which results in several characteristic CNS anomalies. About 90% of babies born with Spina Bifida now live to be adults, about 80% have normal intelligence and about 75% play sports and do other fun activities. Most do well in school, and many play in sports.
Ataxia is a medical condition which results in the lack of muscle coordination that usually affects voluntary movements such as walking, eye movements, speech, and the patient’s ability to swallow.
Spina Bifida: Physiotherapy in the management of meningomyeloceleAyobami Ayodele
Spina bifida is a treatable spinal cord malformation that occurs in varying degrees of severity. Meningomyelocele is associated with abnormal development of the cranial neural tube, which results in several characteristic CNS anomalies. About 90% of babies born with Spina Bifida now live to be adults, about 80% have normal intelligence and about 75% play sports and do other fun activities. Most do well in school, and many play in sports.
Ataxia is a medical condition which results in the lack of muscle coordination that usually affects voluntary movements such as walking, eye movements, speech, and the patient’s ability to swallow.
As part of a class presentation, we attempted to make this to briefly explain what Torticollis meas, the Types of presentation of Torticollis, and Management strategies for a Physiotherapist for Congenital Torticollis especially.
I hope this helps. :)
The pictures and information had been taken from internet, complied to make a brief presentation for the purpose of class presentation.
I do not own any content.
Retraining of motor control basing on understanding of normal movement & analysis of motor dysfunction.
Emphasis of MRP is on practice of specific activities, the training of cognitive control over muscles & movt. Components of activities & conscious elimination of unnecessary muscle activity.
In rehabilitation programme involve – real life activities included.
Dystonia is a movement disorder in which a person's muscles contract uncontrollably. The contraction causes the affected body part to twist involuntarily, resulting in repetitive movements or abnormal postures. Dystonia can affect one muscle, a muscle group, or the entire body.
SCOLIOSIS - Presentation on SCOLIOSIS .docZaherRahat1
Scoliosis is where the spine twists and curves to the side.
It can affect people of any age, from babies to adults, but most often starts in children aged 10 to 15. Scoliosis can improve with treatment, but it is not usually a sign of anything serious and treatment is not always needed if it's mild.
this presentation is about the spondylosis of the cervical region.
there is information about cervical spondylosis, its etiology, epidemiology, sign symptoms and its treatment options.
As part of a class presentation, we attempted to make this to briefly explain what Torticollis meas, the Types of presentation of Torticollis, and Management strategies for a Physiotherapist for Congenital Torticollis especially.
I hope this helps. :)
The pictures and information had been taken from internet, complied to make a brief presentation for the purpose of class presentation.
I do not own any content.
Retraining of motor control basing on understanding of normal movement & analysis of motor dysfunction.
Emphasis of MRP is on practice of specific activities, the training of cognitive control over muscles & movt. Components of activities & conscious elimination of unnecessary muscle activity.
In rehabilitation programme involve – real life activities included.
Dystonia is a movement disorder in which a person's muscles contract uncontrollably. The contraction causes the affected body part to twist involuntarily, resulting in repetitive movements or abnormal postures. Dystonia can affect one muscle, a muscle group, or the entire body.
SCOLIOSIS - Presentation on SCOLIOSIS .docZaherRahat1
Scoliosis is where the spine twists and curves to the side.
It can affect people of any age, from babies to adults, but most often starts in children aged 10 to 15. Scoliosis can improve with treatment, but it is not usually a sign of anything serious and treatment is not always needed if it's mild.
this presentation is about the spondylosis of the cervical region.
there is information about cervical spondylosis, its etiology, epidemiology, sign symptoms and its treatment options.
Positional plagiocephaly from structure to function: Clinical experience of t...Braglia
Objective: Aim of the study is to evaluate disorders related to positional plagiocephaly and introduce a new model of early intervention based on the osteopathic
integrated approach.
Methods: We review clinical experience of the “Program for Neurodevelopmental Follow-up and Pediatric Osteopathy”, a service dedicated to newborns at risk for
developmental disorders.
Results: We present clinical data of 310 newborns followed during first years of life. Data analysis examines perinatal history, general features and disorders that
could be related to plagiocephaly.
Conclusions: The experience confirms that plagiocephaly is not only a problem regarding the shape of the head, it involves the functions. In our Service most babies
(81%) with positional plagiocephaly showed isolated or associated disorders that had an impact on growth, behavior and development. The early intervention based
on the osteopathic integrated approach is addressed not only to the cranial shape but consider the baby as a whole, and the environment where he lives.
Cauda equina syndrome (CSE) is classically featured by the compression of the distal lumbar, sacral and coccygeal nerve roots at the deep end of the conus medullaris at the L1 and L2 vertebral level. Although this disease has a low incidence in the population, ranging from 1:33,000 to 1:100,000 inhabitants, its sequela still generate extreme public healthcare costs (Angus et al., 2015).
The clinical signs and peculiar features of the pathology are: severe back pain, often accompanied by sciatica; saddle(joint)anesthesia; sphincter and sexual dysfunction; and lower limb weakness (Balasubramanian et al.,2010).The presence of all these signs simultaneously is not typically required for diagnosis(Cook et al.,2007). The clinical history and the neurological examination pave to the need for diagnostic confirmation through complementary exams such as computed tomography (CT) and the gold standard, magnetic resonance imaging (MRI)
ADOLESCENT IDIOPATHIC SCOLIOSIS AND ITS ORTHOTICS MANAGEMENT.pptxMritunjay Dev
Adolescent idiopathic scoliosis (AIS) is a type of scoliosis that typically develops during adolescence, between the ages of 10 and 18, and is characterized by an abnormal sideways curvature of the spine. "Idiopathic" means that the cause of the condition is unknown.
Here are some key points about adolescent idiopathic scoliosis:
Onset: AIS usually becomes noticeable during the growth spurt that occurs just before puberty. It can progress during the adolescent growth phase, but it typically stabilizes once the child reaches skeletal maturity.
Curvature: The degree of curvature can vary widely among individuals, ranging from mild to severe. Curves may occur in different regions of the spine and can be classified as thoracic (affecting the upper back), lumbar (affecting the lower back), or both.
Symptoms: In mild cases, AIS may not cause any symptoms or may only cause mild back pain or discomfort. In more severe cases, it can lead to noticeable spinal deformity, uneven shoulders or hips, and difficulty breathing if the curvature compresses the chest cavity.
Diagnosis: AIS is usually diagnosed through a physical examination, including a forward bend test
Bruxism and its effect on periodontiumRamya Ganesh
Bruxism/teeth grinding is a common habit seen among pediatric patients and in older patients with relation to improper occlusion. This habit can cause extreme damage to facial muscles and TMJ. Various treatment options are available including botox injections. Hence as a dentist it is our duty to restore patient's oral health in harmony with other oro facial structures.
Sochima Johnmark Obiekwe presentation on SpondylolisthesisObiekwe Sochi
The PowerPoint presentation on Physiotherapy Management of Spondylolisthesis has been successfully completed. This informative session explored the crucial role of physiotherapy in effectively managing spondylolisthesis, restoring spinal stability, and optimizing functional outcomes for patients.
The presentation covered various aspects of spondylolisthesis, including its definition, classification, common causes, and risk factors. Attendees gained insights into the clinical manifestations of the condition and the resulting limitations in daily activities.
The role of physiotherapy in the comprehensive management of spondylolisthesis was emphasized, highlighting the importance of collaboration between physiotherapists and healthcare professionals. The presentation discussed the comprehensive assessment techniques employed by physiotherapists to evaluate patients accurately.
Attendees learned about the goals of physiotherapy interventions, which included reducing pain and inflammation, restoring spinal stability, improving mobility and flexibility, and enhancing overall function. Evidence-based physiotherapy interventions such as therapeutic exercises, manual therapy techniques, postural education, and ergonomic modifications were showcased, providing practical knowledge for managing spondylolisthesis.
Overall, the completed PowerPoint presentation provided a comprehensive understanding of the vital role physiotherapy plays in the management of spondylolisthesis. Attendees were equipped with practical knowledge and evidence-based strategies to effectively restore stability, alleviate pain, and optimize functional outcomes for patients with this condition.
The completed PowerPoint presentation on Physiotherapy Management of Spondylolisthesis has successfully highlighted the power of physiotherapy in transforming the lives of individuals with spondylolisthesis.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Physiotherapy management of spina bifida ppt by Oluwadamilare Akinwande
1. PHYSIOTHERAPY MANAGEMENT OF SPINA BIFIDA
PRESENTED
BY
OLUWADAMILARE JOSHUA AKINWANDE (PT)
AT
PHYSIOTHERAPY DEPARTMENT
IN
STATE HOSPITAL, ABEOKUTA
2. OUTLINES
• Introduction
• Epidemiology
• Pathogenesis
• Etiology
• Classification
• Clinical Features
• Complications
• Screening and Diagnosis
• Medical and Surgical Management
• Rehabilitation/Physiotherapy Management
• Outcome Measures
• Conclusion
• References
3. INTRODUCTION
• Spina bifida (SB) literally means “cleft spine,” (National Institute of Neurological
Disorders and Stroke [NINDS], 2020).
• It is a type of neural defect resulting from incomplete closure of the neural tube
during embryonic development (Ntimbani, Kelly & Lekgwara, 2020).
• It is also regarded as incomplete closure of the posterior components of vertebrae
as a result of a developmental disorder and the clinical presentation that occurs in
concomitance with this condition (Özaras, 2015).
4. EPIDEMIOLOGY
• SB is the most common non-fatal malformation in the spectrum of neural tube
defects and it is the second leading cause of birth defects after congenital heart
defects (Mohd-Zin, Marwan, Abou Chaar, Ahmad-Annular & Abdul-Aziz, 2017).
• There is slightly varying estimates of the prevalence of SB majorly because the
prevalence of neural tube defects is declining in North America and Western
Europe because of dietary fortification and also because of advanced prenatal
diagnosis that is leading to more elective terminations (Fletcher & Brei, 2010).
• Gender preponderance differs according to country (Mohd-Zin et al., 2017).
5. PATHOGENESIS
• The neural plate which develops between the 2nd and 6th weeks in the
embryologic stage usually closes by curving from two edges and forms the neural
tube. While the brain originates from the cranial part of the neural tube, the spinal
cord develops from the caudal part. Distortions which occur during the closure of
the caudal part of the neural tube during this stage causes SB (Özaras, 2015).
6. ETIOLOGY
• SB has a complex etiology which comprises both genetic and environmental
factors (Fletcher & Brei, 2010).
• Genetic factors tend to play a significant role in the etiology of SB. Its incidence is
fifty times greater than that of the general population if the patient has siblings
with the condition. Genetic predisposition has also been demonstrated in twin and
family studies (Özaras, 2015).
7. • Environmental factors also tend to contribute to the development of SB. These
factors include the use of anti-epileptic drugs which affect folate metabolism in
pregnancy, poorly-managed diabetes and inflammatory diseases experienced
during the first three months of pregnancy (Özaras, 2015).
8. CLASSIFICATION OF SPINA BIFIDA
• As a result of the phenotypic variations in the expression of SB, SB is classified
anatomically as:
Spina Bifida Aperta (SBA): This is regarded as an open SB. This classification
presents when neural elements or membranes are exposed via a bony defect
together with a lack of skin covering. The frequent forms of this classification
include myelomeningocele and myelocele (Ntimbani et al., 2020).
9. Spinal Bifida Occulta (SBO): This is regarded as a closed SB. In this
classification, the bony defect is covered by a skin (Ntimbani et al., 2020).
Examples include lipomyelomeningocele and lipomeningocele (Mohd-Zin et al.,
2017).
10. CLINICAL FEATURES
• The clinical features depend on the form(type) of the SB that a fetus/baby presents
with.
Meningocele: This is characterized by the protrusion of a fluid-filled sac (devoid
of neural matter) through a bony defect present at the site of lesion. This form may
be covered by skin or may not (Mohd-Zin et al., 2017).
11. Myelomeningocele: This is characterized by the protrusion of the spinal cord and
nerves (neural matter) from the spinal canal through a bony defect into a fluid-
filled sac devoid of overlying skin (Mohd-Zin et al., 2017).
Myelocele: This is a form of SB in which the neural matter protrudes through the
spinal canal without overlying sac and skin (Mohd-Zin et al., 2017).
13. PICTORIAL ILLUSTRATION OF FORMS OF SPINA BIFIDA
IMAGE CREDIT: Mohd-Zin et al., 2017 ; Ntimbani et al., 2020 .
14. • SBO forms have features such as dysplastic skin, tufts of hair (hairy patch) and
vestigial tail. These forms include;
Lipomeningocele : A closed SB in which lipid globules are present in the
meninges being overlaid by skin at the lesion site (Mohd-Zin et al., 2017).
Lipomyelomeningocele : A closed SB in which the spinal cord is intermeshed with
lipid globules at the site of lesion (Mohd-Zin et al., 2017).
16. COMPLICATIONS OF SPINA BIFIDA
• These can range from minor physical problems with little functional impairment to
severe physical and mental disabilities. It has been realized that the higher the site
of lesion, the greater the amount of nerve damage and loss of muscle function and
sensation occurs below the level of lesion (NINDS, 2020).
• Individuals with myelomeningocele often present with motor and sensory
neurological deficits below the level of the lesion. Neurogenic bladder and bowel,
Arnold-Chiari type II malformation and the consequent hydrocephalus are often
associated with this form of SB (Copp et al., 2015).
17. • Forms of occulta tend to be asymptomatic (Fletcher & Brei, 2010).
• Secondary motor neuron findings such as reduced deep tendon reflexes, muscle
weakness and hypoesthesia/anesthesia are generally observed in SB.
• Spinal disorders such as kyphosis and scoliosis, hip dislocation, contractures in
the hip and knee, ankle and foot deformities are commonly observed as
orthopedic complications of SB (Özaras, 2015).
18. SCREENING AND DIAGNOSIS
• Maternal serum alpha-fetoprotein screening (MSAFP) can be carried out to check
for elevated level of alpha- fetoprotein (AFP) in the maternal serum during
pregnancy so as to ascertain whether there is neural tube defect or not.
• Amniocentesis can also be carried out to check for elevated level of AFP in the
amniotic fluid surrounding the fetus (Copp et al., 2015).
19. • Owing to the observation that elevated level of AFP is often associated with neural
tube defects, a positive MSAFP and/or amniocentesis is an indication of likely
open SB. This can be confirmed and diagnosed prenatally by carrying out fetal
ultrasonography which usually reveals the defect through the examination of the
fetal spine (Copp et al., 2015).
• SBO is usually not detected by prenatal diagnosis (Fletcher & Brei, 2010).
20. MEDICAL AND SURGICAL MANAGEMENT
• The medical management of individuals with SB is best provided through regular
assessments by a multidisciplinary team, directed by a physician who is
knowledgeable in the care of children with SB, and including a coordinator with
responsibility for the patient follow-up (Copp et al., 2015).
• Fetal surgery has been implemented in a number of specialized centers with
encouraging outcomes (Copp et al., 2015).
• Neonatal surgical closure of the lesion is considered the standard of care against
which all new management options are compared (Mohd-Zin et al., 2017).
21. REHABILITATION/ PHYSIOTHERAPY MANAGEMENT
• The aim of rehabilitation in persons with SB is to improve the quality of life and
independence level of the individuals. The rehabilitation process begins from the
neonatal period and lasts a lifetime.
• Because the people who will be with such individuals and care for them majorly
are their family members , rehabilitation must be family centered and must be
planned taking the features of the family into consideration (Özaras, 2015).
22. • As a result of the various complications that can affect such persons, a
rehabilitation program should be conducted by a team consisting of various health
workers such as specialist physicians from related branches, physiotherapists,
occupational therapists, speech therapists, nurses and clinical psychologists
(Özaras, 2015).
• The exercise regimen of persons with SB should be organized according to the age
and clinical state of the persons. In infants, developmental milestones such as
sitting and standing ought to be followed and early ambulation should be provided
with exercises and orthosis (Özaras, 2015).
23. • A passive range of motion exercises for the joints of the lower extremities
constitutes the base of exercise programs so as to prevent contractures thereby
enhancing independent locomotion of such individuals (Schoenmakers, Uiterwaal,
Gulmans, Gooskens & Helders, 2005).
• For the joints whose tendency to contracture is high due to muscle imbalance,
stretching exercises should be added to the exercise regimen; if necessary,
positioning orthosis and casting should also be applied (Al-Oraib, Tariah &
Alanazi, 2013).
• The strengthening of weak muscles and improving endurance in easily-fatigued
region(s) should be incorporated into the exercise program (Özaras, 2015).
24. • Because osteoporosis is a complication that can be encountered by persons with
SB (particular, those with high level lesions), weight-bearing exercises can be
suggested as a treatment option (Özaras, 2015).
• Pressure sores can cause serious medical disturbances. Therefore, persons with SB
and their caregivers/family members should be taught pressure-relieving
technique/positioning that can help to prevent/minimize such sores (Özaras, 2015).
• The use of an appropriate orthosis provides improvements in locomotion for non-
ambulatory patients and in parameters such as energy consumption, walking speed
and step length for ambulatory patients (Katz-Leurer, Weber, Smerling-Kerem,
Rottem & Meyer, 2004).
25. OUTCOME MEASURES
• Pediatric Evaluation of Disability Inventory
• Gross Motor Function Measure
• Gross Motor Function Classification System
• Functional Mobility Scale
• Functional Independence Measure for Children.
26. CONCLUSION
• The aim of rehabilitation/physiotherapy in persons with SB is to prevent/minimize
complications and improve functional independence as much as possible.
• Researches (Aizawa et al., 2017 ; Karmel-Ross, Cooperman & Van Doren, 1992 ;
; Özaras, 2015 ; ) have revealed that physiotherapy helps to improve mobility and
functional independence in children with SB.
27. REFERENCES
Aizawa, C. Y. P., Morales, M. P., Lundberg, C., Soares de Moura, M. C. D., Pinto, F. C.
G., Voos, M. C., & Hasue, R. H. (2017). Conventional physical therapy and physical
therapy based on reflex stimulation showed similar results in children with
meningocele. Arq Neuropsiquiatr, 75(3), 160-166.
Al-Oraibi, S., Tariah, H. A., & Alanazi, A. (2013). Serial casting versus stretching
technique to treat knee flexion contracture in children with spina bifida: A comparative
study. J Pediatr Rehabil Med, 6, 147-53.
Copp, A. J., Adzick, N. S., Chitty, L. S., Fletcher, J. M., Holmbeck, G. N., & Shaw, G.
M. (2015). Spina bifida. Nat Rev Dis Primers, 1, 15007. doi:10.1038/nrdp.2015.7.
Fletcher, J. M., & Brei, T. J. (2010). Introduction: Spina bifida – a multidisciplinary
perspective. Dev Disabil Res Rev, 16(1), 1–5. doi:10.1002/ddrr.101.
28. Karmel-Ross, K., Cooperman, D. R., & Van Doren, C. L. (1992). The effect of
electrical stimulation on quadriceps femoris muscle torque in children with spina
bifida. Phys Ther, 72, 723-30.
Katz-Leurer, M., Weber, C., Smerling-Kerem, J., Rottem, H., & Meyer, S. (2004).
Prescribing the reciprocal gait orthosis for myelomeningocele children: A different
approach and clinical outcome. Pediatr Rehabil, 7, 105-9.
Mohd-Zin, S. I., Marwan, A. I., Abou Chaar, M. K., Ahmad-Annular, A., & Abdul-
Aziz, N. M. (2017). Spina bifida : Pathogenesis, mechanisms, and genes in mice and
humans. Hindawi Scientifica, 2017, ID 5364827, 2.
• National Institute of Neurological Disorders and Stroke. (2020). Spina bifida fact
sheet. Retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-
Education/Fact-Sheets/Spina-Bifida-fact-Sheet
29. Ntimbani, J., Kelly, A., & Lekgwara, P. (2020). Myelomeningocele: A literature
review. Interdisciplinary Neurosurgery, 19(2020), 100502.
Özaras, N. (2015). Spina bifida and rehabilitation. Turk J Phys Med Rehab 61, 65-9.
Schoenmakers, M. A., Uiterwaal, C. S., Gulmans, V. A., Gooskens, R. H., &
Helders, P. J. (2005). Determinants of functional independence and quality of life in
children with spina bifida. Clin Rehabil,19, 677-85.