Abstract
Purpose The retrospective study was performed to apply the “Hoffer criteria” as a suitable
classification of mobility in spina bifida patients. We looked at clinical parameters
and factors that can be used as predictors for future mobility and development in
these patients.
Materials and Methods Clinical data about ambulation of 90 spina bifida/myelomeningocele patients were
collected using a questionnaire and were completed using the medical records of the
patients. The patients were grouped by their walking distances according to “Hoffeŕs
criteria” (community walker, household walker, exercise walker, nonwalker). The development
of the mobility skills over the years was documented.
Results We grouped 42% of the patients as community walkers, 16% as household, 16% as exercise
walkers, and 27% as always wheelchair dependent (nonwalker). We found significant
correlations between the Hoffer criteria, the level of lesion the walking distance
and the ability to stand upright. There is also a significant relation between the
Hoffer criteria and the frequency of fractures and the age of the patients. The occurrence
of fractures is directly related to the level of lesion and to the level of mobility
in our group of patients. Of all our patients, 39% patients had improved in mobility,
37% patients retained their achieved state, and 24% worsened in their mobility skills.
Conclusions We could see that a stable and ambitious milieu and care in specialized institutions
can achieve a high level of ambulation in spina bifida patients. Most patients are
able to maintain this skill over a long period of time. Predictive factors to maintain
mobility in patients with myelomeningoceles (spina bifida) are not only dependent
on the level of lesion but also rely on the aftercare of the patients too. The data
that were collected are used for counseling of parents and patients.
Keywords
mobility - spina bifida - ambulation
